ISG Summer Meeting 2024

Second - Best Clinical Abstract

Dr Olufemi Aoko
Beaumont Hospital, Dublin

The Impact of Bariatric Endoscopy on NAFLD in Obesity (IBENO) Study

TBA (24S154)

The Impact of Bariatric Endoscopy on NAFLD in Obesity (IBENO) Study

Author(s)

O. Aoko, N. Iqbal, AM. O’Shea, D. Cheriyan, J. Ryan

Department(s)/Institutions

1) Hepatology Unit, Beaumont Hospital Dublin 2) Department of Gastroenterology, Beaumont Hospital Dublin 3) Department of Histopathology, Beaumont Hospital Dublin

Introduction

Endoscopic bariatric therapies (EBT) are minimally invasive procedures that can fill the treatment gap that exists in the management of non-alcoholic fatty liver disease (NAFLD). Intragastric balloon (IGB), the most common EBT, can potentially play a key role in the management of NAFLD.

Aims/Background

To evaluate the efficacy of IGB in the management of NAFLD.

Method

We conducted a prospective observational study using the Orbera365 IGB over 6 months. In addition, we obtained liver biopsies pre- and post-IGB placement, via endoscopic ultrasound (EUS).

Results

A total of 21 patients were followed up prospectively from November 2022 to January 2024. The mean age was 49.1(31-60), mean BMI 42.4(31-55.6)kg/m2, and 13(61.9%) patients were males. Eighteen (86%) patients completed the study; 2 patients required early IGB removal and 1 patient withdrew from the study before IGB placement. The mean total body weight loss (TBWL) was 13.5%, with a mean excess weight loss (EWL) of 35.4%. There were significant reductions in primary endpoints – BMI (42.4+/-6.23kg/m2 vs 36.6+/-5.9kg/m2, p<0.001), body weight (125+/-28.14kg vs 107+/-21kg, p<0.001), liver stiffness (14.2+/-6.01kPa vs 8.6+/-5.82kPa, p<0.01) and steatosis (343+/-45.3dB/m vs 287.6+/-76.7dB/m, p-value <0.05). Furthermore, significant reductions were observed in secondary endpoints - liver enzymes, Hba1c, and insulin resistance. On histology, there was a significant reduction in steatosis [2 (0-3) vs 1 (0-2), p<0.01], and a non-significant reduction in NAFLD activity score (NAS) [3.5 (0-5) vs 3 (0-5), p=0.21]; no significant change in liver fibrosis was seen.

Conclusions

IGB therapy appears to be effective in the management of NAFLD, especially given the limited treatment options currently available.

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