Researchers at Imperial College have been awarded £1.2 million to trial left gastric artery embolisation (LGAE) as a weight loss treatment in patients. LGAE is a minimally invasive treatment most commonly used to treat upper gastrointestinal bleeding by reducing blood supply to a specific area at the top of the stomach. Under x-ray vision embolisation particles (large molecules that are soluble in water) are injected through a catheter to the top part of the stomach to block the blood flow, in a procedure that takes under an hour.
This treatment reduces the production of the hormone ghrelin, which controls appetite, and early evidence in animals suggests that this treatment could be used for obesity. Previous research has suggested that patients having stomach embolisation for bleeding stomach ulcers in the top of the stomach lost more weight than patients having embolisation to other organs or other areas of the stomach.
“There is a real need to develop new treatments which are clinically effective, less invasive, more appealing to prospective patients and cost effective to the NHS,” explained Mr Ahmed R Ahmed, Clinical Senior Lecturer in Bariatric Surgery at Imperial College London and Consultant Bariatric Surgeon at Imperial College Healthcare NHS Trust. “Obesity is a major health issue that has a high cost for patients and wider society as it’s associated with a range of health problems such as diabetes, heart disease and cancer. There are currently a range of treatments such as dietary programmes, drugs and surgery. However, for some patients these treatments can be ineffective, carry side effects, and be very expensive. There is a real need to develop new treatments which are clinically effective, less invasive, more appealing to prospective patients and cost effective to the NHS. Our research could help address this unmet clinical need, as preliminary research suggests LGAE has potential as a minimally invasive treatment for weight loss. The new funding will help us assess for the first time how effective this treatment is for our patients.”
Some of the current treatments for people with obesity include dietary advice, drugs and weight loss surgery known as gastric bypass surgery, which can be very effective in keeping excess weight off and in improving blood sugar levels in diabetics. However, some patients decide against surgery, which can cause complications such as abdominal pain, chronic nausea, vomiting and debilitating low blood sugar levels. Also, weight loss dietary programmes can be ineffective for some patients.
The team will recruit 76 patients, who have a BMI between 35-50, to a one year study which begins in December. Thirty-eight patients will have the LGAE procedure and 38 patients a placebo procedure at St Mary’s Hospital, part of Imperial College Healthcare NHS Trust, and at UCL Hospitals NHS Trust. The patients will then be followed up to see the impact of their treatment on weight loss and compare the two groups. They will also attend appointments with a specialist dietician and obesity medicine physician as part of the hospital’s routine post-surgical lifetime programme.
“There is a real need to expand the weight loss treatments currently on offer for patients, especially those who don’t want to go down a surgical route,” added Dr Prashant Patel, Clinical Research Fellow at Imperial College London. “LGAE has been shown to be a promising minimally invasive treatment but there’s not yet been enough research for us to say how effective it might be. Our research will help us to answer this question and see if it could be a viable treatment for people living with obesity.”
The research is funded by the National Institute for Health Research (NIHR) Efficacy and Mechanism Evaluation programme.