EUS-Guided Intragastric Injection of Botulinum Toxin A in the Preoperative Treatment of Super-Obese Patients: a Randomized Clinical Trial

Background Obesity is a disease that is highly prevalent in Brazil, and the associated comorbidities represent a major global public health challenge. Botulinum toxin type A (BTX-A) is a potent neurotoxin and inhibitor of gastric smooth muscle activity. In theory, BTX-A administration should promote...

Full description

Saved in:
Bibliographic Details
Published in:Obesity surgery 2019-01, Vol.29 (1), p.32-39
Main Authors: de Moura, Eduardo Guimarães Hourneaux, Ribeiro, Igor Braga, Frazão, Mariana Souza Varela, Mestieri, Luiz Henrique Mazzonetto, de Moura, Diogo Turiani Hourneaux, Dal Bó, Creusa Maria Roveri, Brunaldi, Vitor Ottoboni, de Moura, Eduardo Turiani Hourneaux, Nunes, Gabriel Cairo, Bustamante, Fábio Alberto Castillo, dos Passos Galvão Neto, Manoel, Matuguma, Sergio Eiji, Bernardo, Wanderley Marques, Santo, Marco Aurélio
Format: Article
Language:English
Subjects:
Botulinum toxin
Botulinum Toxins, Type A - administration & dosage
Botulinum Toxins, Type A - pharmacology
Botulinum Toxins, Type A - therapeutic use
Clinical trials
Endosonography - methods
Gastric Emptying - drug effects
Gastrointestinal surgery
Health risk assessment
Humans
Medicine
Medicine & Public Health
Obesity
Obesity, Morbid - drug therapy
Obesity, Morbid - surgery
Original Contributions
Preoperative Care - methods
Surgery
Weight control
Weight Loss - drug effects
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Obesity is a disease that is highly prevalent in Brazil, and the associated comorbidities represent a major global public health challenge. Botulinum toxin type A (BTX-A) is a potent neurotoxin and inhibitor of gastric smooth muscle activity. In theory, BTX-A administration should promote early satiety and weight loss because it delays gastric emptying by inhibiting acetylcholine-mediated peristalsis, which is primarily responsible for gastric motility. Because results in the literature are discrepant, the efficacy of intragastric injections of BTX-A as a primary treatment for obesity remains unknown. The objective of this prospective, double-blind, single-center randomized study was to evaluate the effects of endoscopic ultrasound-guided intragastric BTX-A injections, as a bridge to bariatric surgery, in super-obese patients. Methods Thirty-two super-obese patients were randomized to one of two groups: BTX-A, in which 200 units of BTX-A were injected into the gastric antrum and body; and control, in which the same injections were performed with 0.9% saline. Weight, body mass index (BMI), and loss of excess weight were measured monthly over a 6-month period. Gastric emptying scintigraphy was performed before and after the procedure. Results The patients in both groups showed significant weight loss over the course of the study ( p  
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-018-3470-y