Obese patients with nonalcoholic steatohepatitis (NASH) have an increased risk of cirrhosis if they fail to achieve significant weight loss. In a study published recently in Clinical Gastroenterology and Hepatology, researchers analyzed the effects of intragastric balloon (IGB) placement on metabolic and histologic features of NASH.

This open-label prospective study assessed 21 patients with early hepatic fibrosis. The patient population comprised of 81% female, mean age 54 years and average body mass index of 44 kg/m². The primary outcome measure was changes in liver histology parameters after IGB, including change in nonalcoholic fatty liver disease activity score (NAS) and fibrosis score. Changes in weight, body mass index, waist to hip ratio, aminotransaminases, fasting levels of lipids, fasting glucose, glycosylated hemoglobin, and magnetic resonance elastography (MRE)-detected liver stiffness were also assessed.

Six months following IGB, there was 11.7±7.7% mean total body weight loss, with significant reductions in HbA1c of 1.3±0.5%. Waist circumference was shown to decrease by 14.4 ± 2.2 cm. There was improvement in NAS in 18 out of 20 patients (90%), with a median reduction of 3 points (range, 1-4 points). Sixteen of 20 patients (80%) exhibited improvements of 2 points or more. Fibrosis appeared to improve by 1.17 stages in 15% of patients, while MRE-detected fibrosis improved by 1.5 stages in 10 patients (50%). Half of the patients attained the Food and Drug Administration approved endpoints for NASH resolution and fibrosis improvement. Percent total body weight loss had no correlation with reductions in NAS or fibrosis. Apart from post-procedural pain, noted in 5% of patients, there were no serious adverse events.

IGB was shown to facilitate significant metabolic and histologic improvements in NASH. This is a safe and effective management option for NASH, in combination with a prescribed diet and exercise program.

Source: Bazerbachi F, Vargas EJ, Rizk M, et al. Intragastric Balloon Placement Induces Significant Metabolic and Histologic Improvement in Patients With Nonalcoholic Steatohepatitis. Clin Gastroenterol Hepatol. 2020 Apr 30.