Background
Controversies persist regarding the effect of intragastric injection of botulinum
toxin A for the treatment of obesity.
Objective
To assess the efficacy of intragastric botulinum toxin injection for the treatment
of obesity.
Design
A systematic literature review was conducted by using the core databases. Pre- and
posttreatment body weight data were extracted and analyzed by using Hedges’ g. A random-effects model was applied. The methodological quality of the enrolled studies
was assessed by the risk of bias table and Newcastle-Ottawa Scale. Publication bias
was evaluated via the funnel plot, trim and fill method, Egger’s test, and rank correlation
test.
Setting
Meta-analysis of 8 studies.
Patients
A total of 115 patients (79 treated vs 36 placebo).
Intervention
Intragastric botulinum toxin A injection.
Main Outcome Measurements
Hedges’ g, calculated from pre- and posttreatment body weight data and comparison of body weight
changes between treatment and placebo group.
Results
The treatment group was associated with weight loss in a pre/post comparative approach
and compared with the placebo group (Hedges’ g: −0.443; 95% confidence interval, −0.845 to −0.040; P = .031; and Hedges’ g: −0.521; 95% confidence interval, −0.956 to −0.085; P = .019). Wide area injection including the fundus or body rather than the antrum
only was associated with weight loss. Multiple injections (>10) were associated with
weight loss. However, a large amount of botulinum toxin A (500 IU) was not associated
with weight loss. Sensitivity analyses showed consistent results. Meta-regression
for the botulinum toxin A dose and number of injections showed consistent results.
Publication bias was not detected.
Conclusion
In this analysis, intragastric injection of botulinum toxin A is effective for the
treatment of obesity.
Abbreviations:
CI (confidence interval), NOS (Newcastle-Ottawa Scale), RoB (risk of bias), SMD (standardized mean difference)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: March 10, 2015
Accepted:
December 1,
2014
Received:
September 17,
2014
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this article.
Identification
Copyright
© 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Reviewing the reviewers: critical appraisal of “Effect of intragastric injection of botulinum toxin A for the treatment of obesity: a meta-analysis and meta-regression”Gastrointestinal EndoscopyVol. 83Issue 2
- PreviewGastrointestinal Endoscopy recently published a systematic review with meta-analysis evaluating the use of botulinum toxin A, intragastric, for the treatment of obesity.1 Because of the importance of this issue,2 we assessed the systematic review using a similar methodology to that applied previously2 based on the guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement3 and the Assessment of Multiple Systematic Reviews (AMSTAR).4
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