TY - JOUR
T1 - Adjustable intragastric balloon for treatment of obesity
T2 - a multicentre, open-label, randomised clinical trial
AU - Abu Dayyeh, Barham K.
AU - Maselli, Daniel B.
AU - Rapaka, Babusai
AU - Lavin, Thomas
AU - Noar, Mark
AU - Hussan, Hisham
AU - Chapman, Christopher G.
AU - Popov, Violeta
AU - Jirapinyo, Pichamol
AU - Acosta, Andres
AU - Vargas, Eric J.
AU - Storm, Andrew C.
AU - Bazerbachi, Fateh
AU - Ryou, Marvin
AU - French, Matthew
AU - Noria, Sabrena
AU - Molina, Daniel
AU - Thompson, Christopher C.
N1 - Funding Information:
This study was funded by Spatz Medical and performed under the guidance of the US FDA for premarketing approval of this device in the USA. We thank all the patients who participated in this study.
Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/11/27
Y1 - 2021/11/27
N2 - Background: Intragastric balloons are anatomy-preserving, minimally invasive obesity therapies. Enhanced tolerance and durability could help broaden clinical adoption. We investigated the safety and efficacy of an adjustable intragastric balloon (aIGB) in adults with obesity. Methods: In this prospective, multicentre, open-label, randomised clinical trial done at seven US sites, adults aged 22–65 years with obesity were randomly assigned (2:1) to aIGB with lifestyle intervention or lifestyle intervention alone (control) for 32 weeks. Balloon volume could be increased to facilitate weight loss or decreased for tolerability. Coprimary endpoints included mean percentage total bodyweight loss and responder rate (≥5% total bodyweight loss) at 32 weeks. We used a multiple imputed intention-to-treat population analysis. This study was registered with ClinicalTrials.gov, NCT02812160. Findings: Between Aug 9, 2016, and Dec 7, 2018, we randomly assigned 288 patients to aIGB (n=187 [65%]) or control (n=101 [35%]) groups. Mean total bodyweight loss at 32 weeks was 15·0% (95% CI 13·9–16·1) in the aIGB group versus 3·3% (2·0–4·6) in the control group (p<0·0001). Clinical response was observed in 171 (92%) patients in the aIGB group. Adjustments to the aIGB occurred in 145 (80%) patients for weight loss plateau or intolerance. Upward volume adjustment facilitated an additional mean 5·2% (4·5–5·8) total bodyweight loss. Downward volume adjustment allowed 21 (75%) patients in the aIGB group to complete the full duration of therapy. Intolerance caused early removal of the device in 31 (17%) patients. No micronutrient deficiencies were observed in the aIGB cohort. Device-related serious adverse events were observed in seven (4%) patients, without any deaths. Interpretation: When aIGB was combined with lifestyle modification, significant weight loss was achieved and maintained for 6 months following removal. Balloon volume adjustability permitted individualised therapy, maximising weight loss and tolerance. Funding: Spatz Medical.
AB - Background: Intragastric balloons are anatomy-preserving, minimally invasive obesity therapies. Enhanced tolerance and durability could help broaden clinical adoption. We investigated the safety and efficacy of an adjustable intragastric balloon (aIGB) in adults with obesity. Methods: In this prospective, multicentre, open-label, randomised clinical trial done at seven US sites, adults aged 22–65 years with obesity were randomly assigned (2:1) to aIGB with lifestyle intervention or lifestyle intervention alone (control) for 32 weeks. Balloon volume could be increased to facilitate weight loss or decreased for tolerability. Coprimary endpoints included mean percentage total bodyweight loss and responder rate (≥5% total bodyweight loss) at 32 weeks. We used a multiple imputed intention-to-treat population analysis. This study was registered with ClinicalTrials.gov, NCT02812160. Findings: Between Aug 9, 2016, and Dec 7, 2018, we randomly assigned 288 patients to aIGB (n=187 [65%]) or control (n=101 [35%]) groups. Mean total bodyweight loss at 32 weeks was 15·0% (95% CI 13·9–16·1) in the aIGB group versus 3·3% (2·0–4·6) in the control group (p<0·0001). Clinical response was observed in 171 (92%) patients in the aIGB group. Adjustments to the aIGB occurred in 145 (80%) patients for weight loss plateau or intolerance. Upward volume adjustment facilitated an additional mean 5·2% (4·5–5·8) total bodyweight loss. Downward volume adjustment allowed 21 (75%) patients in the aIGB group to complete the full duration of therapy. Intolerance caused early removal of the device in 31 (17%) patients. No micronutrient deficiencies were observed in the aIGB cohort. Device-related serious adverse events were observed in seven (4%) patients, without any deaths. Interpretation: When aIGB was combined with lifestyle modification, significant weight loss was achieved and maintained for 6 months following removal. Balloon volume adjustability permitted individualised therapy, maximising weight loss and tolerance. Funding: Spatz Medical.
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U2 - 10.1016/S0140-6736(21)02394-1
DO - 10.1016/S0140-6736(21)02394-1
M3 - Article
C2 - 34793746
AN - SCOPUS:85119674986
SN - 0140-6736
VL - 398
SP - 1965
EP - 1973
JO - The Lancet
JF - The Lancet
IS - 10315
ER -