Amaral Gabriel de Oliveira, Schmitt João Pedro, Delgado Lucas Monteiro, Meine Gilmara Coelho
Department of Medicine, FEEVALE University, Novo Hamburgo, Brazil.
Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Endosc Int Open. 2025 Sep 3;13:a26812859. doi: 10.1055/a-2681-2859. eCollection 2025.
Intragastric balloon (IGB) is a minimally invasive and reversible endoscopic option for treating obesity. This systematic review and meta-analysis compared the effectiveness of IGB versus standard medical therapy (SMT) for obesity management, including studies with a minimum treatment duration of 6 months. Subgroup analyses were performed based on IGB type, baseline mean body mass index (BMI), and use of pharmacological therapy in the SMT group.
We searched for randomized controlled trials (RCTs) in MEDLINE, EMBASE, and Cochrane Library databases. Outcomes were evaluated at 6, 9, and 12 months after initiation of treatment. A random-effects model was used to calculate the pooled mean difference (MD) with 95% confidence interval (CI) for continuous outcomes.
We included 15 RCTs (1961 patients). Compared with SMT, IGB significantly improved the percentage of excess weight loss at 6 months (MD 16.80; 95% CI 9.22-24.38), 9 months (MD 14.36; 95% CI 7.67-21.04), and 12 months (MD 13.10; 95% CI 10.43-15.77). IGB also showed superior results in percentage of total weight loss, absolute weight loss, and BMI reduction at all time points compared with SMT. There were significant subgroup differences for some outcomes according to IGB type and baseline mean BMI.
In obese adults, IGB is more effective than SMT for weight loss at 6, 9, and 12 months.
胃内球囊（IGB）是一种用于治疗肥胖症的微创且可逆的内镜治疗方法。本系统评价和荟萃分析比较了IGB与标准药物治疗（SMT）在肥胖管理中的有效性，纳入的研究治疗持续时间至少为6个月。根据IGB类型、基线平均体重指数（BMI）以及SMT组中药物治疗的使用情况进行亚组分析。
我们在MEDLINE、EMBASE和Cochrane图书馆数据库中检索随机对照试验（RCT）。在治疗开始后的6、9和12个月评估结果。采用随机效应模型计算连续结果的合并平均差（MD）及95%置信区间（CI）。
我们纳入了15项RCT（1961例患者）。与SMT相比，IGB在6个月时显著提高了超重减轻百分比（MD 16.80；95%CI 9.22 - 24.38），9个月时（MD 14.36；95%CI 7.67 - 21.04），以及12个月时（MD 13.10；95%CI 10.43 - 15.77）。在所有时间点，IGB在总体重减轻百分比、绝对体重减轻和BMI降低方面也显示出优于SMT的结果。根据IGB类型和基线平均BMI，某些结果存在显著的亚组差异。
在肥胖成年人中，IGB在6、9和12个月时减重效果比SMT更有效。
