Endoscopy 2023; 55(11): 1028-1034
DOI: 10.1055/a-2117-6274
Innovations and brief communications

Improvements in hepatic steatosis, obesity, and insulin resistance in adults with nonalcoholic fatty liver disease after the primary obesity surgery endoluminal 2.0 procedure

Maryam AlKhatry
1   Department of Gastroenterology, Obaidulla Hospital, Ras Al Khaimah, Emirates Health Services, Ministry of Health, United Arab Emirates
,
Babusai Rapaka
2   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
Daniel B. Maselli
2   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
2   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
2   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
3   Gastroenterology Department, University of Sao Paulo Medical School, Sao Paulo, Brazil
,
Tala Mahmoud
2   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
Rabih Ghazi
2   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
Farah Abdul Razzak
2   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
Khushboo Gala
2   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
Imad Joudah
1   Department of Gastroenterology, Obaidulla Hospital, Ras Al Khaimah, Emirates Health Services, Ministry of Health, United Arab Emirates
,
Fedaa Housen
1   Department of Gastroenterology, Obaidulla Hospital, Ras Al Khaimah, Emirates Health Services, Ministry of Health, United Arab Emirates
,
Sana Al Qadi
1   Department of Gastroenterology, Obaidulla Hospital, Ras Al Khaimah, Emirates Health Services, Ministry of Health, United Arab Emirates
,
2   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
2   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
Barham K. Abu Dayyeh
2   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
› Author Affiliations
This study was supported by the UAE Ministry of Health and USGI Medical (San Clemente, CA) provided study devices for the study on a collaborative research agreement.

Trial Registration: ClinicalTrials.gov Registration number (trial ID): NCT05611567 Type of study: Prospective, open-label, single center


Abstract

Background The primary obesity surgery endoluminal 2.0 (POSE 2.0) procedure involves full-thickness gastric body plications to narrow the stomach using durable suture anchor pairs. We evaluated POSE 2.0 as a treatment strategy for nonalcoholic fatty liver disease (NAFLD) in patients with obesity.

Methods Adults with obesity and NAFLD were prospectively allocated based on their preference to undergo POSE 2.0 with lifestyle modification or lifestyle modification alone (control). Primary end points were improvement in controlled attenuation parameter (CAP) and resolution of hepatic steatosis at 12 months. Secondary end points included %total body weight loss (%TBWL), change in serum measures of hepatic steatosis and insulin resistance, and procedure safety.

Results 42 adult patients were included (20 in the POSE 2.0 arm and 22 in the control arm). At 12 months, POSE 2.0 significantly improved CAP, whereas lifestyle modification alone did not (P < 0.001 for POSE 2.0; P = 0.24 for control). Similarly, both resolution of steatosis and %TBWL were significantly higher with POSE 2.0 than with control at 12 months. Compared with controls, POSE 2.0 significantly improved liver enzymes, hepatic steatosis index, and aspartate aminotransferase to platelet ratio at 12 months. There were no serious adverse events.

Conclusion POSE 2.0 was effective for NAFLD in patients with obesity, with good durability and safety profile.

Tables 1 s–6 s



Publication History

Received: 06 February 2023

Accepted after revision: 26 June 2023

Accepted Manuscript online:
26 June 2023

Article published online:
24 August 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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