GLP-1 Analogues as a Complementary Therapy in Patients after Metabolic Surgery: a Systematic Review and Qualitative Synt

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GLP-1 Analogues as a Complementary Therapy in Patients after Metabolic Surgery: a Systematic Review and Qualitative Synthesis Romano Schneider 1 & Marko Kraljević 1 & Ralph Peterli 1 & Theresa V. Rohm 2,3 & Jennifer M. Klasen 1 & Claudia Cavelti-Weder 2,3 & Tarik Delko 1 Received: 14 April 2020 / Revised: 25 May 2020 / Accepted: 28 May 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract The evidence is strong that bariatric surgery is superior to medical treatment in terms of weight loss and comorbidities in patients with severe obesity. However, a considerable part of patients presents with unsatisfactory response in the long term. It remains unclear whether postoperative administration of glucagon-like peptide-1 analogues can promote additional benefits. Therefore, a systematic review of the current literature on the management of postoperative GLP-1 analogue usage after metabolic surgery was performed. From 4663 identified articles, 6 met the inclusion criteria, but only one was a randomized controlled trial. The papers reviewed revealed that GLP-1 analogues may have beneficial effects on additional weight loss and T2D remission postoperatively. Thus, the use of GLP-1 analogues in addition to surgery promises good results concerning weight loss and improvements of comorbidities and can be used in patients with unsatisfactory results after bariatric surgery. Keywords GLP-1 . GLP-1 analogues . metabolic surgery . Bariatric surgery

Introduction Surgical Treatment of Obesity Bariatric surgery is gaining popularity worldwide, and the total number of procedures continues to rise. The most common procedures are the

laparoscopic Roux-en-Y gastric bypass (LRYGB) and the laparoscopic sleeve gastrectomy (LSG). Additionally, less common techniques are available as bariatric options, such as the biliopancreatic diversion with or without duodenal switch (BPD/BPD-DS), the adjustable gastric band (AGB), one-

Romano Schneider and Marko Kraljević Contributed equally and share first authorship. * Romano Schneider romano.b.schneider@gmail.com

Claudia Cavelti-Weder claudia.cavelti-weder@usb.ch Tarik Delko tarik.delko@clarunis.ch

Marko Kraljević marko.kraljevic@gmail.com 1

Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, P.O. BOX, CH-4002 Basel, Switzerland

Theresa V. Rohm theresa.rohm@unibas.ch

2

Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, CH-4031 Basel, Switzerland

Jennifer M. Klasen Jennifer.Klasen@clarunis.ch

3

Department of Biomedicine, University of Basel, University Hospital Basel, CH-4031 Basel, Switzerland

Ralph Peterli ralph.peterli@clarunis.ch

OBES SURG

anastomosis gastric bypass (OAGB), and single anastomosis duodeno-ileal bypass (SADI). LRYGB provides excellent evidence-based results in terms of weight loss and a decrease in obesity-related comorbidities in the long term [1, 2]. LSG represents an alternative to LRYGB and provides com