Meta-analysis of randomized controlled trials for the development of the International Federation for Surgery of Obesity and Metabolic Disorders-European Chapter (IFSO-EC) guidelines on multimodal strategies for the surgical treatment of obesity.
| Title: | Meta-analysis of randomized controlled trials for the development of the International Federation for Surgery of Obesity and Metabolic Disorders-European Chapter (IFSO-EC) guidelines on multimodal strategies for the surgical treatment of obesity. |
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| Authors: | De Luca M; Department of General, Emergency and Metabolic Surgery, Rovigo Hospital, Rovigo, Italy.; Belluzzi A; Department of General, Emergency and Metabolic Surgery, Rovigo Hospital, Rovigo, Italy.; Angrisani L; Public Health Department, School of Medicine, University Federico II of Naples, Naples, Italy.; Bandini G; Diabetic Foot Unit, University of Florence and AOU-Careggi, Florence, Italy.; Becattini B; Department of Molecular and Clinical Medicine, Institute of Medicine, Göteborg, Sweden.; Bueter M; Department of Surgery and Transplantation, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Carrano FM; Department of Medical Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University, Rome, Italy.; Chiappetta S; Bariatric and Metabolic Surgery Unit, Department of General and Laparoscopic Surgery, Ospedale Evangelico Betania, Naples, Italy.; Cohen RV; The Center for Obesity and Diabetes, Hospital Alemao Oswaldo Cruz, Sao Paulo, Brazil.; Copaescu C; Department of Surgery, Ponderas Academic Hospital, Bucharest, Romania.; Di Lorenzo N; Department of Surgical Sciences, University of Tor Vergata, Rome, Italy.; Emous M; Department of Bariatric and Metabolic Surgery, Medical Center, Center for Obesity Northern-Netherlands (CON), Leeuwarden, The Netherlands.; Felsenreich DM; Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria.; Fried M; OB Klinika-Center for Treatment of Obesity and Metabolic Disorders, Prague, Czech Republic.; Himpens J; Delta CHIREC Hospital (Belgian Registry), Brussels, Belgium.; Iannelli A; Digestive Surgery and Liver Transplantation Unit, Université Côte d'Azur, Nice, France.; Navarra G; University of Messina, Messina, Italy.; Nienhuijs S; Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.; Olmi S; San Marco Hospital GSD, Zingonia, Italy.; Parmar C; Department of Surgery, Whittington Hospital, University College, London, UK.; Prager G; Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria.; Pujol-Rafols J; HM Delfos, Barcelona, Spain.; Ragghianti B; Diabetic Foot Unit, University of Florence and AOU-Careggi, Florence, Italy.; Ribeiro R; Centro Multidisciplinar Do Tratamento da Obesidade, Hospital Lusíadas Amadora e Lisboa, Amadora, Portugal.; Ruiz-Úcar E; General and Digestive Surgery Department, Fuenlabrada University Hospital, Rey Juan Carlos University, Madrid, Spain.; Sakran N; Department of General Surgery, Holy Family Hospital, Nazareth, Israel.; The Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel.; Salminen P; Department of Surgery, University of Turku, Turku, Finland.; Scoccimarro D; Diabetic Foot Unit, University of Florence and AOU-Careggi, Florence, Italy.; Stenberg E; Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.; Stier C; Department of Surgery, Bariatric Endoscopy, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.; Taskin HE; Department of Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.; Puy RV; Endocrine-Metabolic and Bariatric Surgery Unit, Vall Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain.; Monami M; Diabetic Foot Unit, University of Florence and AOU-Careggi, Florence, Italy. |
| Corporate Authors: | Panel for the IFSO‐EC on the Surgical Treatment of Obesity Using Multimodal Strategies |
| Source: | Diabetes, obesity & metabolism [Diabetes Obes Metab] 2025 Jun; Vol. 27 (6), pp. 3347-3356. Date of Electronic Publication: 2025 Apr 08. |
| Publication Type: | Journal Article; Meta-Analysis |
| Language: | English |
| Journal Info: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 100883645 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1463-1326 (Electronic) Linking ISSN: 14628902 NLM ISO Abbreviation: Diabetes Obes Metab Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford : Wiley-Blackwell, c1999- |
| MeSH Terms: | Bariatric Surgery*/methods ; Obesity*/surgery ; Obesity*/therapy; Humans ; Randomized Controlled Trials as Topic ; Combined Modality Therapy ; Weight Loss ; Practice Guidelines as Topic ; Treatment Outcome ; Quality of Life ; Body Mass Index |
| Abstract: | Background: Randomized, controlled trials (RCTs) comparing the effectiveness of metabolic bariatric surgery (MBS) in addition to one or more treatment interventions for obesity (i.e., lifestyle structured interventions-LSI, medical therapy-MT, obesity management medication-OMM or endobariatric procedures-EP) are lacking. This study aims to assess the effectiveness of multiple simultaneous (before or immediately after MBS) interventions for treating obesity.; Methods: We performed a meta-analysis including all RCTs enrolling patients undergoing different MBS procedures add-on to other anti-obesity strategies (LSI, MT, OMM or ES) versus MBS alone, with a duration of at least 6 months. The primary outcome was BMI at the end-point; secondary end-points included percentage total and excess weight loss (%TWL%, and EBWL%), total weight loss (TWL), fasting plasma glucose (FPG), HbA1c, surgical and non-surgical severe adverse events (SAE), mortality, remission of type 2 diabetes, hypertension, dyslipidemia and health-related quality of life (HR-QoL).; Results: A total of 25 RCTs were retrieved. The addition of either OMM (i.e., liraglutide) or EP (i.e., intragastric balloon-IB, endosleeve-ES) to MBS was associated with a significantly lower BMI at the end-point (p = 0.040). The addition of liraglutide only to MBS was associated with a greater %EWL%, but not %TWL and TBWL (p = 0.008). Three trials evaluated end-point HbA1c, showing a significant reduction in favour of liraglutide as an add-on therapy to MBS (p = 0.007). There was no mortality.; Conclusions: MBS combined with non-surgical approaches appears more effective than MBS alone in reducing BMI. Further RCTs on combined therapies to MBS for severe obesity are needed to enhance the tailoring of treatment for severe obesity.; (© 2025 John Wiley & Sons Ltd.) |
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| Contributed Indexing: | Investigator: M De Luca; A Belluzzi; P Salminen; M Bueter; J Pujol-Rafols; N Sakran; C Stier; HE Taskin; S Chiappetta; FM Carrano; N Di Lorenzo; S Nienhuijs; RV Puy; E Stenberg; M Emous; G Prager; J Himpens; DM Felsenreich; A Iannelli; C Parmar; C Copaescu; M Fried; E Ruiz-Úcar; M Monami; Keywords: GLP‐1 analogue; bariatric surgery; meta‐analysis; obesity therapy |
| Entry Date(s): | Date Created: 20250408 Date Completed: 20250503 Latest Revision: 20250507 |
| Update Code: | 20260130 |
| DOI: | 10.1111/dom.16352 |
| PMID: | 40197859 |
| Database: | MEDLINE |
Journal Article; Meta-Analysis