Endoscopic Duodenal-Jejunal Bypass Liner Treatment for Type 2 Diabetes and Obesity: Glycemic and Cardiovascular Disease Risk Factor Improvements in 1,022 Patients Treated Worldwide

Ryder, Robert E.; Laubner, Katharina; Benes, Marek; Haluzı́k, Martin; Munro, Lynne; Frydenberg, Harry; Teare, Julian; Ruban, Aruchana; Fishman, Sigal; Santo, Erwin; Stengel, R; Jonge, Charlotte de; Greve, Jan; Cohen, Ricardo; Aboud, Cristina Mamédio; Holtmann, Gerald; Rich, Graeme; McMaster, Jess J.; Battelino, Tadej; Kotnik, Primož; Byrne, James P.; Mason, John C.; Bessell, J. R.; Bascomb, Jeanine; Kow, Lillian; Collins, Janes; Chisholm, Jacob; Pferschy, Peter N.; Sourij, Harald; Cull, Melissa L.; Wyres, Melanie C.; Drummond, Russell; McGowan, Barbara; Amiel, Stephanie A.; Yadagiri, Mahi; Gupta, Piya Sen; Aberle, Jens; Seufert, Jochen

doi:10.2337/dc22-1952

Cited by 6 publications

(8 citation statements)

References 4 publications

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“…Conversely, in Europe, safety data have not been as alarming. To support this, an independent, secure, online registry was established by the Association of British Clinical Diabetologists for the collection of safety and efficacy data of EndoBarrier‐treated patients globally 25 . The data showed significant weight loss and improvements in HbA1c, blood pressure, and cholesterol at the time of removal but the authors specifically highlighted its safety profile in the 1022 patients.…”

Section: Methodsmentioning

confidence: 99%

“…To support this, an independent, secure, online registry was established by the Association of British Clinical Diabetologists for the collection of safety and efficacy data of EndoBarrier-treated patients globally. 25 The data showed significant weight loss and improvements in HbA1c, blood pressure, and cholesterol at the time of removal but the authors specifically highlighted its safety profile in the 1022 patients. Of the available data, there were 43 (4.2%) severe adverse events requiring early removal including bleeding (n = 22, 2.3%), liver abscess (n = 11, 1.1%), and pancreatitis or cholecystitis (n = 4, 0.4%).…”

Section: Endoluminal Bypass Linersmentioning

confidence: 99%

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Updates in metabolic bariatric endoscopy

Simons

Sharaiha

2023

Digestive Endoscopy

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Obesity and its associated comorbid conditions have been increasing globally. Endoscopic bariatric and metabolic therapies (EBMTs) were initially designed to replicate bariatric surgery physiology for those who are not or choose not to be surgical candidates. Now, newer procedures target the complicated pathophysiology underlying obesity and its comorbidities. EBMT has been categorized based on its therapeutic target (stomach or small intestine), but innovations have expanded to include extraintestinal organs including the pancreas. Gastric EBMTs, namely space‐occupying balloons, gastroplasty with suturing or plication, and aspiration therapy, are primarily used for weight loss. Small bowel EBMTs are designed to cause malabsorption, epithelial endocrine remodeling, and other changes to intestinal physiology to ultimately improve the metabolic comorbidities of obesity rather than induce weight loss alone. These include duodenal mucosal resurfacing, endoluminal bypass sleeves, and incisionless anastomosis systems. Extraluminal or pancreatic EBMT is aimed to restore the production of normal pancreatic proteins that are involved in the progression of type 2 diabetes. This review discusses the current and new technologies of metabolic bariatric endoscopy, their pros and cons, and areas for future research.

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Section: Methodsmentioning

confidence: 99%

Section: Endoluminal Bypass Linersmentioning

confidence: 99%

Updates in metabolic bariatric endoscopy

Simons

Sharaiha

2023

Digestive Endoscopy

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“…Within the Worldwide DJBL Registry, 4.2% of patients reportedly experienced SAEs, notably bleeding (2.3%), hepatic abscesses (1.1%), and pancreatitis/cholecystitis (0.4%). 23 …”

Section: Clinical Outcomesmentioning

confidence: 99%

Role of endoscopic duodenojejunal bypass liner in obesity management and glycemic control

Igi,

de Oliveira,

Matar

et al. 2024

Clin Endosc

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The treatment of obesity and its comorbidities ranges from clinical management involving lifestyle changes and medications to bariatric and metabolic surgery. Various endoscopic bariatric and metabolic therapies recently emerged to address an important therapeutic gap by offering a less invasive alternative to surgery that is more effective than conservative therapies. This article comprehensively reviews the technical aspects, mechanism of action, outcomes, and future perspectives of one of the most promising endoscopic bariatric and metabolic therapies, named duodenojejunal bypass liner. The duodenojejunal bypass liner mimics the mechanism of Roux-en-Y gastric bypass by preventing food contact with the duodenum and proximal jejunum, thereby initiating a series of hormonal changes that lead to delayed gastric emptying and malabsorptive effects. These physiological changes result in significant weight loss and improved metabolic control, leading to better glycemic levels, preventing dyslipidemia and non-alcoholic fatty liver disease, and mitigating cardiovascular risk. However, concern exists regarding the safety profile of this device due to the reported high rates of severe adverse events, particularly liver abscesses. Ongoing technical changes aiming to reduce adverse events are being evaluated in clinical trials and may provide more reliable data to support its routine use in clinical practice.

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“…More recently, registry data from the Association of British Clinical Diabetologists has shown that among 1022 treated patients, there is a significant reduction in HbA1c (−1.3%; SD 1.5) between baseline and device removal at one year. Serious adverse events (SAEs) occurred in 4.2% with 11 liver abscesses [27]. Although these safety issues raise concerns, the experience with EndoBarrier TM showed that the small bowel can be targeted by endoscopy with clear evidence of an efficacy signal.…”

Section: Implantable Bypass Linersmentioning

confidence: 99%

Metabolic Endoscopy: Should Gastroenterologists Be Treating Type 2 Diabetes?

Norton,

Papaefthymiou,

Telese

et al. 2024

Gastrointestinal Disorders

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Type 2 diabetes (T2D) is one of the most significant and fast-growing health challenges of the 21st century. Despite the variety of available glucose-lowering agents, many patients do not attain or maintain adequate glycaemic control. Bariatric surgery demonstrates a profound anti-diabetic effect, which is almost immediate and weight-loss independent. The significant improvement in diabetes after bariatric surgery together with the endoscopic accessibility of the duodenum has led to the development of new metabolic endoscopic procedures that capitalise on the importance of the proximal small bowel in glycaemic control. Clinical trials have shown a clear efficacy signal, and now, several devices are undergoing evaluation as primary T2D treatments. Establishing where these procedures fit into the treatment algorithms for T2D and how they can be combined with modern pharmacotherapies is needed in a rapidly changing landscape. Ultimately, through metabolic endoscopy, gastroenterologists are on the cusp of providing safe and effective treatments for the multidisciplinary management of T2D.

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Endoscopic Duodenal-Jejunal Bypass Liner Treatment for Type 2 Diabetes and Obesity: Glycemic and Cardiovascular Disease Risk Factor Improvements in 1,022 Patients Treated Worldwide

Cited by 6 publications

References 4 publications

Updates in metabolic bariatric endoscopy

Updates in metabolic bariatric endoscopy

Role of endoscopic duodenojejunal bypass liner in obesity management and glycemic control

Metabolic Endoscopy: Should Gastroenterologists Be Treating Type 2 Diabetes?

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