Reversal of Long-Term Weight Regain After Roux-en-Y Gastric Bypass Using Liraglutide or Surgical Revision. A Prospective Study
Purpose This study investigates whether pharmacotherapy with liraglutide is similarly effective in reversing weight regain more than 6 years after Roux-en-Y gastric bypass (RYGB) as revisional surgery aimed at restoring restriction. Methods Ninety-five consecutive patients (11 male, 84 female; mean...
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| Veröffentlicht in: | Obesity surgery 2021-01, Vol.31 (1), p.93-100 |
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| creator | Horber, Fritz F. Steffen, Rudolf |
| description | Purpose
This study investigates whether pharmacotherapy with liraglutide is similarly effective in reversing weight regain more than 6 years after Roux-en-Y gastric bypass (RYGB) as revisional surgery aimed at restoring restriction.
Methods
Ninety-five consecutive patients (11 male, 84 female; mean BMI 45 ± 6 kg/m
2
) undergoing RYGB 9 ± 4 years ago were treated for 24 months as follows: Patients, who gained less than 10% from weight NADIR, served as controls and were provided lifestyle counseling (DC,
n
= 30). The others were allowed to choose between three different treatment groups: daily s.c. administration of liraglutide (LG,
n
= 34); endosurgery using Apollo’s Overstitch System™ (ES,
n
= 15), or implantation of a Fobi-ring with pouch resizing (FP,
n
= 16).
Results
Controls kept their weight stable during 24 months of study (− 0.1 ± 1.7 kg/m
2
). Weight loss was 4.8 ± 2.9 kg/m
2
for LG and 5.5 ± 2.9 kg/m
2
for FP, both losing more than 85% of regained weight from weight NADIR (
p
|
| doi_str_mv | 10.1007/s11695-020-04856-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7808975</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2425898222</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-45bda9d7b7d635ea16274a6cb74dfc70d75a567b88093bb583a68b2b2bc699243</originalsourceid><addsrcrecordid>eNp9kUtv1DAUhS0EokPhD7BAltiwcbGdxI8N0lBBQRoJNG2FWFmOcyd1lbGndjIiG347LlPKY4G8sKz73XPv8UHoOaMnjFL5OjMmdEMop4TWqhFkfoAWTFJVnlw9RAuqBSVK8-oIPcn5mlLOBOeP0VHFhWY1ZQv0fQ17SNkOOG7wKoaeXEDa4i_g-6sRr6G3PuDlZoSE13H6RiCQr_jM5jF5h9_OO5szvsw-9Hjlk-2HafQd4Jjw-ZR674puGeCzj-EEL_HnFPMO3Oj3gM_HqZufokcbO2R4dncfo8v37y5OP5DVp7OPp8sVcbWsR1I3bWd1J1vZiaoBW2zI2grXyrrbOEk72dhGyFYpqqu2bVRlhWp5OU5ozevqGL056O6mdgudgzAmO5hd8lubZhOtN39Xgr8yfdwbqajSsikCr-4EUryZII9m67ODYbAB4pQNr3mjtOKcF_TlP-h1nFIo9gol5S3DWKH4gXLlT3KCzf0yjJrbeM0hXlPiNT_jNXNpevGnjfuWX3kWoDoAuZRCD-n37P_I_gA6KbIp</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2477822211</pqid></control><display><type>article</type><title>Reversal of Long-Term Weight Regain After Roux-en-Y Gastric Bypass Using Liraglutide or Surgical Revision. A Prospective Study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Horber, Fritz F. ; Steffen, Rudolf</creator><creatorcontrib>Horber, Fritz F. ; Steffen, Rudolf</creatorcontrib><description>Purpose
This study investigates whether pharmacotherapy with liraglutide is similarly effective in reversing weight regain more than 6 years after Roux-en-Y gastric bypass (RYGB) as revisional surgery aimed at restoring restriction.
Methods
Ninety-five consecutive patients (11 male, 84 female; mean BMI 45 ± 6 kg/m
2
) undergoing RYGB 9 ± 4 years ago were treated for 24 months as follows: Patients, who gained less than 10% from weight NADIR, served as controls and were provided lifestyle counseling (DC,
n
= 30). The others were allowed to choose between three different treatment groups: daily s.c. administration of liraglutide (LG,
n
= 34); endosurgery using Apollo’s Overstitch System™ (ES,
n
= 15), or implantation of a Fobi-ring with pouch resizing (FP,
n
= 16).
Results
Controls kept their weight stable during 24 months of study (− 0.1 ± 1.7 kg/m
2
). Weight loss was 4.8 ± 2.9 kg/m
2
for LG and 5.5 ± 2.9 kg/m
2
for FP, both losing more than 85% of regained weight from weight NADIR (
p
< 0.001). In contrast, weight loss in ES was 1.0 ± 0.9 kg/m
2
(i.e., 20% of regained weight). Thirty-seven percent of FP experienced serious complications (
p
< 0.05) in contrast to the other groups. An improved prevalence of hypertension and dyslipidemia was observed in LG and FP (
p
< 0.02) 24 months after intervention.
Conclusions
Weight regain during more than 6 years after RYGB can be safely and effectively reversed with liraglutide. Compared with revisional surgery, pharmacotherapy with liraglutide was low risk and resulted in an important improvement in hypertension and dyslipidemia. Therefore, daily subcutaneous injections of liraglutide are a valid option to treat weight regain after RYGB.</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-020-04856-y</identifier><identifier>PMID: 32691401</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Body Mass Index ; Drug therapy ; Female ; Gastric Bypass ; Gastrointestinal surgery ; Humans ; Hypertension ; Liraglutide ; Male ; Medicine ; Medicine & Public Health ; Obesity, Morbid - surgery ; Original Contributions ; Prospective Studies ; Reoperation ; Retrospective Studies ; Surgery ; Treatment Outcome ; Weight Gain</subject><ispartof>Obesity surgery, 2021-01, Vol.31 (1), p.93-100</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-45bda9d7b7d635ea16274a6cb74dfc70d75a567b88093bb583a68b2b2bc699243</citedby><cites>FETCH-LOGICAL-c474t-45bda9d7b7d635ea16274a6cb74dfc70d75a567b88093bb583a68b2b2bc699243</cites><orcidid>0000-0003-3604-581X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-020-04856-y$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-020-04856-y$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32691401$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Horber, Fritz F.</creatorcontrib><creatorcontrib>Steffen, Rudolf</creatorcontrib><title>Reversal of Long-Term Weight Regain After Roux-en-Y Gastric Bypass Using Liraglutide or Surgical Revision. A Prospective Study</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Purpose
This study investigates whether pharmacotherapy with liraglutide is similarly effective in reversing weight regain more than 6 years after Roux-en-Y gastric bypass (RYGB) as revisional surgery aimed at restoring restriction.
Methods
Ninety-five consecutive patients (11 male, 84 female; mean BMI 45 ± 6 kg/m
2
) undergoing RYGB 9 ± 4 years ago were treated for 24 months as follows: Patients, who gained less than 10% from weight NADIR, served as controls and were provided lifestyle counseling (DC,
n
= 30). The others were allowed to choose between three different treatment groups: daily s.c. administration of liraglutide (LG,
n
= 34); endosurgery using Apollo’s Overstitch System™ (ES,
n
= 15), or implantation of a Fobi-ring with pouch resizing (FP,
n
= 16).
Results
Controls kept their weight stable during 24 months of study (− 0.1 ± 1.7 kg/m
2
). Weight loss was 4.8 ± 2.9 kg/m
2
for LG and 5.5 ± 2.9 kg/m
2
for FP, both losing more than 85% of regained weight from weight NADIR (
p
< 0.001). In contrast, weight loss in ES was 1.0 ± 0.9 kg/m
2
(i.e., 20% of regained weight). Thirty-seven percent of FP experienced serious complications (
p
< 0.05) in contrast to the other groups. An improved prevalence of hypertension and dyslipidemia was observed in LG and FP (
p
< 0.02) 24 months after intervention.
Conclusions
Weight regain during more than 6 years after RYGB can be safely and effectively reversed with liraglutide. Compared with revisional surgery, pharmacotherapy with liraglutide was low risk and resulted in an important improvement in hypertension and dyslipidemia. Therefore, daily subcutaneous injections of liraglutide are a valid option to treat weight regain after RYGB.</description><subject>Body Mass Index</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Gastric Bypass</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Liraglutide</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obesity, Morbid - surgery</subject><subject>Original Contributions</subject><subject>Prospective Studies</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Weight Gain</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUtv1DAUhS0EokPhD7BAltiwcbGdxI8N0lBBQRoJNG2FWFmOcyd1lbGndjIiG347LlPKY4G8sKz73XPv8UHoOaMnjFL5OjMmdEMop4TWqhFkfoAWTFJVnlw9RAuqBSVK8-oIPcn5mlLOBOeP0VHFhWY1ZQv0fQ17SNkOOG7wKoaeXEDa4i_g-6sRr6G3PuDlZoSE13H6RiCQr_jM5jF5h9_OO5szvsw-9Hjlk-2HafQd4Jjw-ZR674puGeCzj-EEL_HnFPMO3Oj3gM_HqZufokcbO2R4dncfo8v37y5OP5DVp7OPp8sVcbWsR1I3bWd1J1vZiaoBW2zI2grXyrrbOEk72dhGyFYpqqu2bVRlhWp5OU5ozevqGL056O6mdgudgzAmO5hd8lubZhOtN39Xgr8yfdwbqajSsikCr-4EUryZII9m67ODYbAB4pQNr3mjtOKcF_TlP-h1nFIo9gol5S3DWKH4gXLlT3KCzf0yjJrbeM0hXlPiNT_jNXNpevGnjfuWX3kWoDoAuZRCD-n37P_I_gA6KbIp</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Horber, Fritz F.</creator><creator>Steffen, Rudolf</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3604-581X</orcidid></search><sort><creationdate>20210101</creationdate><title>Reversal of Long-Term Weight Regain After Roux-en-Y Gastric Bypass Using Liraglutide or Surgical Revision. A Prospective Study</title><author>Horber, Fritz F. ; Steffen, Rudolf</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-45bda9d7b7d635ea16274a6cb74dfc70d75a567b88093bb583a68b2b2bc699243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Body Mass Index</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Gastric Bypass</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Liraglutide</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obesity, Morbid - surgery</topic><topic>Original Contributions</topic><topic>Prospective Studies</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Weight Gain</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Horber, Fritz F.</creatorcontrib><creatorcontrib>Steffen, Rudolf</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Horber, Fritz F.</au><au>Steffen, Rudolf</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reversal of Long-Term Weight Regain After Roux-en-Y Gastric Bypass Using Liraglutide or Surgical Revision. A Prospective Study</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>31</volume><issue>1</issue><spage>93</spage><epage>100</epage><pages>93-100</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Purpose
This study investigates whether pharmacotherapy with liraglutide is similarly effective in reversing weight regain more than 6 years after Roux-en-Y gastric bypass (RYGB) as revisional surgery aimed at restoring restriction.
Methods
Ninety-five consecutive patients (11 male, 84 female; mean BMI 45 ± 6 kg/m
2
) undergoing RYGB 9 ± 4 years ago were treated for 24 months as follows: Patients, who gained less than 10% from weight NADIR, served as controls and were provided lifestyle counseling (DC,
n
= 30). The others were allowed to choose between three different treatment groups: daily s.c. administration of liraglutide (LG,
n
= 34); endosurgery using Apollo’s Overstitch System™ (ES,
n
= 15), or implantation of a Fobi-ring with pouch resizing (FP,
n
= 16).
Results
Controls kept their weight stable during 24 months of study (− 0.1 ± 1.7 kg/m
2
). Weight loss was 4.8 ± 2.9 kg/m
2
for LG and 5.5 ± 2.9 kg/m
2
for FP, both losing more than 85% of regained weight from weight NADIR (
p
< 0.001). In contrast, weight loss in ES was 1.0 ± 0.9 kg/m
2
(i.e., 20% of regained weight). Thirty-seven percent of FP experienced serious complications (
p
< 0.05) in contrast to the other groups. An improved prevalence of hypertension and dyslipidemia was observed in LG and FP (
p
< 0.02) 24 months after intervention.
Conclusions
Weight regain during more than 6 years after RYGB can be safely and effectively reversed with liraglutide. Compared with revisional surgery, pharmacotherapy with liraglutide was low risk and resulted in an important improvement in hypertension and dyslipidemia. Therefore, daily subcutaneous injections of liraglutide are a valid option to treat weight regain after RYGB.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32691401</pmid><doi>10.1007/s11695-020-04856-y</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3604-581X</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Obesity surgery, 2021-01, Vol.31 (1), p.93-100 |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Body Mass Index Drug therapy Female Gastric Bypass Gastrointestinal surgery Humans Hypertension Liraglutide Male Medicine Medicine & Public Health Obesity, Morbid - surgery Original Contributions Prospective Studies Reoperation Retrospective Studies Surgery Treatment Outcome Weight Gain |
| title | Reversal of Long-Term Weight Regain After Roux-en-Y Gastric Bypass Using Liraglutide or Surgical Revision. A Prospective Study |
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