Endoscopic Ultrasound Guided Gastric Botulinum Toxin Injections versus Glucagon like peptide 1 Receptor Agonist in weight loss. A Prospective randomized study

Abstract

Abstract Purpose In this study, we compared safety, feasibility, and efficacy of Endoscopic Ultrasound (EUS) guided Botulinum toxin A (BTA) injection versus Glucagon like Peptide 1 (GLP-1) agonists in treatment of obesity. The two intervention techniques were paired with a number of lifestyle changes, such as a diet of 2000 calories per day for males and 1800 calories per day for women, and moderate daily cardiovascular exercise (at least 30 minutes, five days a week) for four months. Over the course of a 16-week follow-up period, body weight was measured. Methods 40 patients were included in this study, 20 in each group. The 1st group underwent BTA injections via EUS, while the 2nd group received GLP 1 receptor agonist. Results In the 1st group, there was a significant weight loss from (107.30±11.41 kg) at baseline to (94.75±12.65 kg) after 4 months of treatment (p value <0.001). In the 2nd there was significant weight loss from (123.28±17.17 kg) at baseline to (109.75±14.37 kg) after 4 months (p value <0.001). Significant reduction of BMI was reported in both groups after 4 months of treatment; 1st group, from (40.53±4.41 kg/m2) at baseline to (35.78±4.82 kg/m2) (p. value <0.001), 2nd group from (44.15±5.94 kg/m2) to (39.40±5.68 kg/m2) (p value <0.001). Conclusion EUS guided BTA injections and GLP-1 RA receptor agonist injections both could be effective and safe procedures for treatment of obesity. Trial registration: NCT05268627, initial release 27/1/2022