Poster Session : PS 0770 ; Upper GI Tract : Effect of Intragastric Injection of Botulinum Toxin a for the Treatment of Obesity: A Systematic Review and Meta-Analysis

Background: Controversies regarding effect of intragastric injection of botulinum toxin A for the treatment of obesity still remain. Methods: A systematic literature review was conducted using the core databases (PubMed, EMBASE, and the Cochrane Library). Pre- and post-treatment body weight data were extracted and analyzed using Hedges`s g. The analysis was performed divided by 2 ways which are pre-post comparative approach in botulinum injected group and comparison with placebo injected group. A random effect 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 through the funnel plot, trim and fi ll method, Egger`s test, and rank correlation test. Results: A total of 139 patients was enrolled from 8 studies (91 treated vs. 49 placebo group) and followed up for median 12 weeks (IQR: 6.5-16 weeks). Overall, treatment group was associated with weight loss in a pre-post comparative approach and compared to the placebo group (Hedges`s g: -0.619, 95% CI: -1.090, -0.148, P = 0.01; Hedges`s g: -0.650, 95% CI: -1.035, -0.265, P = 0.001). Wide area injection including fundus or body rather than the antrum only injection was associated with weight loss. Multiple injection number (above 10) was associated with weight loss. However, large amount of botulinum (more than 500 IU) was not associated with weight loss. Sensitivity analyses showed consistent results. Publication bias was not detected. Conclusions: In this analysis, intragastric injection of botulinum toxin A is effective for the treatment of obesity.