BACKGROUND/AIMS: Botulinum toxin A (BTX-A) is an inhibitor of muscular contractions in both striated and smooth muscle. The purpose of this study was to observe the safety and efficacy of endoscopic injections of BTX-A into the gastric wall in obese patients. METHODOLOGY:Twenty obese patients (BMI >28 kg/m2) were randomized into two groups: Group 1 (200 U BTX-A) and Group 2 (300 U BTX-A). For each patient, 20 puncture sites were selected into the gastric wall. Body weights and BMIs were recorded and gastric emptying times were determined before treatment and 1, 4 and 12 weeks after treatment. Blood samples for cholesterol, triglycerides, insulin, leptin, motilin, peptide tyrosine (PYY) and ghrelin levels were obtained before treatment and 1, 4 and 12 weeks after treatment. RESULTS:Nineteen patients completed the follow-up. Both groups showed significant body weight and BMI decrease (p<0.05) with decreased TG levels. The gastric emptying times were longer than those before treatment in both groups, especially at the 1-week point (p<0.05). A significant decrease in fasting ghrelin levels in all 19 obese patients was found after BTX-A administration 4 weeks later, and PYY levels in all 19 patients decreased, especially at the 12-week point. No severe complications were observed. CONCLUSIONS:Endoscopic multi-punctures of BTX-A including fundic injections may decrease body weight and BMI by delaying the gastric emptying time. The effect of BTX-A on ghrelin levels may also be involved in the reduction of appetite.
RCT Entities:
BACKGROUND/AIMS: Botulinum toxin A (BTX-A) is an inhibitor of muscular contractions in both striated and smooth muscle. The purpose of this study was to observe the safety and efficacy of endoscopic injections of BTX-A into the gastric wall in obesepatients. METHODOLOGY: Twenty obesepatients (BMI >28 kg/m2) were randomized into two groups: Group 1 (200 U BTX-A) and Group 2 (300 U BTX-A). For each patient, 20 puncture sites were selected into the gastric wall. Body weights and BMIs were recorded and gastric emptying times were determined before treatment and 1, 4 and 12 weeks after treatment. Blood samples for cholesterol, triglycerides, insulin, leptin, motilin, peptide tyrosine (PYY) and ghrelin levels were obtained before treatment and 1, 4 and 12 weeks after treatment. RESULTS: Nineteen patients completed the follow-up. Both groups showed significant body weight and BMI decrease (p<0.05) with decreased TG levels. The gastric emptying times were longer than those before treatment in both groups, especially at the 1-week point (p<0.05). A significant decrease in fasting ghrelin levels in all 19 obesepatients was found after BTX-A administration 4 weeks later, and PYY levels in all 19 patients decreased, especially at the 12-week point. No severe complications were observed. CONCLUSIONS: Endoscopic multi-punctures of BTX-A including fundic injections may decrease body weight and BMI by delaying the gastric emptying time. The effect of BTX-A on ghrelin levels may also be involved in the reduction of appetite.
Authors: Eric J Vargas; Fateh Bazerbachi; Gerardo Calderon; Larry J Prokop; Victoria Gomez; M Hassan Murad; Andres Acosta; Michael Camilleri; Barham K Abu Dayyeh Journal: Clin Gastroenterol Hepatol Date: 2019-04-04 Impact factor: 11.382
Authors: Mark Topazian; Michael Camilleri; Felicity T Enders; Jonathan E Clain; Ferga C Gleeson; Michael J Levy; Elizabeth Rajan; Vandana Nehra; Ross A Dierkhising; Maria L Collazo-Clavell; Nicholas J Talley; Matthew M Clark Journal: Clin Gastroenterol Hepatol Date: 2012-10-09 Impact factor: 11.382
Authors: Raed M Tayyem; Haitham G Qandeel; Hamzeh I Al-Balas; Farah R Tayyem; Jehad Z Fataftah; Mahmoud I Al-Balas Journal: Saudi J Gastroenterol Date: 2022 Jul-Aug Impact factor: 3.214