Obesity Clinical Trial
— ByBandSleeveOfficial title:
Gastric Bypass, Adjustable Gastric Banding or Sleeve Gastrectomy Surgery to Treat Severe and Complex Obesity: a Multi-centre Randomised Controlled Trial
Verified date | May 2023 |
Source | University of Bristol |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Obesity is an increasing health problem in the United Kingdom (UK) and is predicted to worsen. In the UK and worldwide the three most commonly performed operations are laparoscopic adjustable gastric banding ('BAND surgery'), laparoscopic gastric bypass ('BYPASS') and laparoscopic sleeve gastrectomy ('SLEEVE'). All lead to weight loss, but they are associated with different problems. This study (BYBANDSLEEVE) is a randomised trial with a target recruitment of 1341 patients in twelve hospitals and its aim is to compare the effectiveness, cost effectiveness and acceptability of BAND, BYPASS and SLEEVE surgery.
Status | Completed |
Enrollment | 1351 |
Est. completion date | March 31, 2023 |
Est. primary completion date | September 30, 2022 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: 1. Male or female patients 2. Over 18 years of age 3. Referred for bariatric surgery according to the National Institute for Health and Care Excellence (NICE) guidelines - BMI of 40kg/m2 or more, OR BMI of 35 kg/m2 to 40 kg/m2 and other significant disease (e.g. type 2 diabetes or high blood pressure) OR BMI of 30 kg/m2 or more and recent onset diabetes OR Asian family origin with lower BMI and recent onset diabetes, that could improve with weight loss 4. Has been or is willing to receive intensive management in a specialist tier 3 obesity service 5. Fit for anaesthesia and surgery 6. Committed to follow-up and able to complete quality of life questionnaires 7. Able to provide written informed consent. Exclusion Criteria: 1. Previous gastric surgery or surgery for severe and complex obesity 2. Previous abdominal surgery or gastro-intestinal (GI) condition that precludes one or more of Band, Bypass or Sleeve 3. Large abdominal ventral hernia 4. Pregnancy (women who have given birth and women planning pregnancy will NOT be excluded) 5. Crohn's disease 6. Liver cirrhosis and portal hypertension 7. Systemic lupus erythematosis 8. Known silicone allergy 9. Hiatus hernia >5cm 10. Other clinical/psychological reason, to be specified 11. Active participation in another interventional research study which might interfere with By-Band-Sleeve |
Country | Name | City | State |
---|---|---|---|
United Kingdom | Heart of England NHS Foundation Trust | Birmingham | |
United Kingdom | Royal Bournemouth and Christchurch Hospitals | Bournemouth | |
United Kingdom | North Bristol NHS Trust | Bristol | |
United Kingdom | Royal Derby Hospital | Derby | |
United Kingdom | St James University Hospital, Leeds | Leeds | |
United Kingdom | Homerton University Hospital | London | |
United Kingdom | Imperial College Healthcare NHS Trust | London | |
United Kingdom | Queen Alexandra Hospital | Portsmouth | |
United Kingdom | University Hospital Southampton | Southampton | |
United Kingdom | Sunderland Royal Hospital | Sunderland | |
United Kingdom | Musgrove Park Hospital | Taunton | |
United Kingdom | Royal Cornwall Hospital | Truro |
Lead Sponsor | Collaborator |
---|---|
University of Bristol | University of Birmingham, University of Oxford |
United Kingdom,
Blazeby JM, Byrne J, Welbourn R. What is the most effective operation for adults with severe and complex obesity? BMJ. 2014 Mar 14;348:g1763. doi: 10.1136/bmj.g1763. No abstract available. — View Citation
Coulman KD, Hopkins J, Brookes ST, Chalmers K, Main B, Owen-Smith A, Andrews RC, Byrne J, Donovan JL, Mazza G, Reeves BC, Rogers CA, Thompson JL, Welbourn R, Wordsworth S, Blazeby JM; BARIACT working group. A Core Outcome Set for the Benefits and Adverse Events of Bariatric and Metabolic Surgery: The BARIACT Project. PLoS Med. 2016 Nov 29;13(11):e1002187. doi: 10.1371/journal.pmed.1002187. eCollection 2016 Nov. — View Citation
Coulman KD, Howes N, Hopkins J, Whale K, Chalmers K, Brookes S, Nicholson A, Savovic J, Ferguson Y, Owen-Smith A, Blazeby J; By-Band-Sleeve Trial Management Group; Blazeby J, Welbourn R, Byrne J, Donovan J, Reeves BC, Wordsworth S, Andrews R, Thompson JL, Mazza G, Rogers CA. A Comparison of Health Professionals' and Patients' Views of the Importance of Outcomes of Bariatric Surgery. Obes Surg. 2016 Nov;26(11):2738-2746. doi: 10.1007/s11695-016-2186-0. — View Citation
Doble B, Welbourn R, Carter N, Byrne J, Rogers CA, Blazeby JM, Wordsworth S; By-Band-Sleeve Trial Management Group. Multi-Centre Micro-Costing of Roux-En-Y Gastric Bypass, Sleeve Gastrectomy and Adjustable Gastric Banding Procedures for the Treatment of Severe, Complex Obesity. Obes Surg. 2019 Feb;29(2):474-484. doi: 10.1007/s11695-018-3553-9. — View Citation
Doble B, Wordsworth S, Rogers CA, Welbourn R, Byrne J, Blazeby JM; By-Band-Sleeve Trial Management Group. What Are the Real Procedural Costs of Bariatric Surgery? A Systematic Literature Review of Published Cost Analyses. Obes Surg. 2017 Aug;27(8):2179-2192. doi: 10.1007/s11695-017-2749-8. Erratum In: Obes Surg. 2017 Aug;27(8):2193. — View Citation
Donovan JL, Paramasivan S, de Salis I, Toerien M. Clear obstacles and hidden challenges: understanding recruiter perspectives in six pragmatic randomised controlled trials. Trials. 2014 Jan 6;15:5. doi: 10.1186/1745-6215-15-5. — View Citation
Fermont JM, Blazeby JM, Rogers CA, Wordsworth S; By-Band-Sleeve Study Management Group. The EQ-5D-5L is a valid approach to measure health related quality of life in patients undergoing bariatric surgery. PLoS One. 2017 Dec 18;12(12):e0189190. doi: 10.1371/journal.pone.0189190. eCollection 2017. — View Citation
Hopkins JC, Blazeby JM, Rogers CA, Welbourn R. The use of adjustable gastric bands for management of severe and complex obesity. Br Med Bull. 2016 Jun;118(1):64-72. doi: 10.1093/bmb/ldw012. Epub 2016 Mar 31. — View Citation
Hopkins JC, Howes N, Chalmers K, Savovic J, Whale K, Coulman KD, Welbourn R, Whistance RN, Andrews RC, Byrne JP, Mahon D, Blazeby JM; By-Band Trial Management Group. Outcome reporting in bariatric surgery: an in-depth analysis to inform the development of a core outcome set, the BARIACT Study. Obes Rev. 2015 Jan;16(1):88-106. doi: 10.1111/obr.12240. Epub 2014 Nov 30. — View Citation
Paramasivan S, Rogers CA, Welbourn R, Byrne JP, Salter N, Mahon D, Noble H, Kelly J, Mazza G, Whybrow P, Andrews RC, Wilson C, Blazeby JM, Donovan JL. Enabling recruitment success in bariatric surgical trials: pilot phase of the By-Band-Sleeve study. Int J Obes (Lond). 2017 Nov;41(11):1654-1661. doi: 10.1038/ijo.2017.153. Epub 2017 Jul 3. — View Citation
Rogers CA, Reeves BC, Byrne J, Donovan JL, Mazza G, Paramasivan S, Andrews RC, Wordsworth S, Thompson J, Blazeby JM, Welbourn R; By-Band-Sleeve study investigators. Adaptation of the By-Band randomized clinical trial to By-Band-Sleeve to include a new intervention and maintain relevance of the study to practice. Br J Surg. 2017 Aug;104(9):1207-1214. doi: 10.1002/bjs.10562. — View Citation
Rogers CA, Welbourn R, Byrne J, Donovan JL, Reeves BC, Wordsworth S, Andrews R, Thompson JL, Roderick P, Mahon D, Noble H, Kelly J, Mazza G, Pike K, Paramasivan S, Blencowe N, Perkins M, Porter T, Blazeby JM. The By-Band study: gastric bypass or adjustable gastric band surgery to treat morbid obesity: study protocol for a multi-centre randomised controlled trial with an internal pilot phase. Trials. 2014 Feb 11;15:53. doi: 10.1186/1745-6215-15-53. — View Citation
Rooshenas L, Elliott D, Wade J, Jepson M, Paramasivan S, Strong S, Wilson C, Beard D, Blazeby JM, Birtle A, Halliday A, Rogers CA, Stein R, Donovan JL; ACST-2 study group; By-Band-Sleeve study group; Chemorad study group; CSAW study group; Optima prelim study group; POUT study group. Conveying Equipoise during Recruitment for Clinical Trials: Qualitative Synthesis of Clinicians' Practices across Six Randomised Controlled Trials. PLoS Med. 2016 Oct 18;13(10):e1002147. doi: 10.1371/journal.pmed.1002147. eCollection 2016 Oct. — View Citation
Rooshenas L, Scott LJ, Blazeby JM, Rogers CA, Tilling KM, Husbands S, Conefrey C, Mills N, Stein RC, Metcalfe C, Carr AJ, Beard DJ, Davis T, Paramasivan S, Jepson M, Avery K, Elliott D, Wilson C, Donovan JL; By-Band-Sleeve study group; CSAW study group; HAND-1 study group; Optima prelim study group; Romio feasibility study group. The QuinteT Recruitment Intervention supported five randomized trials to recruit to target: a mixed-methods evaluation. J Clin Epidemiol. 2019 Feb;106:108-120. doi: 10.1016/j.jclinepi.2018.10.004. Epub 2018 Oct 16. — View Citation
Welbourn R, le Roux CW, Owen-Smith A, Wordsworth S, Blazeby JM. Why the NHS should do more bariatric surgery; how much should we do? BMJ. 2016 May 11;353:i1472. doi: 10.1136/bmj.i1472. No abstract available. — View Citation
* Note: There are 15 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | The proportion achieving loss of greater than 50% of excess weight at three years. | The proportion achieving loss of greater than 50% of excess weight at three years (calculated as 100×[BMI at 3 years - BMI at randomisation1] / [BMI at randomisation - 25]) | Three years | |
Primary | Health-related Quality of Life (HRQoL) | HRQoL at three 3 years, will be assessed using the EQ-5D-5L | Three years | |
Secondary | Change in BMI over time adjusted for BMI at randomisation | Change in BMI over time adjusted for BMI at randomisation | Three years | |
Secondary | Percentage weight loss at 3 years | Percentage weight loss at 3 years | Three years | |
Secondary | Waist circumference at 3 years | Waist circumference at 3 years | Three years | |
Secondary | Time taken from randomisation to reach first loss of at least 50% of excess BMI | Time taken from randomisation to reach first loss of at least 50% of excess BMI | Three years | |
Secondary | Time taken from first losing 50% excess BMI to first relapse | Time taken from first losing 50% excess BMI to first relapse (defined as weight re-gain such that the target of at least 50% of excess weight loss is no longer met) | Three years | |
Secondary | Generic and symptom specific Health-related Quality of Life (HRQOL) | Impact of Weight on Quality of Life (IWQOL-Lite) | Three years | |
Secondary | Generic and symptom specific Health-related Quality of Life (HRQOL) | The Gastrointestinal Quality of Life Index | Three years | |
Secondary | Generic and symptom specific Health-related Quality of Life (HRQOL) | Eating Habits Questionnaire | Three years | |
Secondary | Generic and symptom specific Health-related Quality of Life (HRQOL) | SF-12v2 Health Survey | Three years | |
Secondary | Generic and symptom specific Health-related Quality of Life (HRQOL) | Hospital Anxiety and Depression Scale (HADS). | Three years | |
Secondary | Resource use to three years | Use of health service resources over the three-year study period. | Three years | |
Secondary | Standard healthcare blood tests | Standard NHS nutritional blood tests will be performed at each assessment. | Three years | |
Secondary | Dietary recall | Measures of 24 hour recall eating using a standardised and validated interview process | Three years | |
Secondary | Binge eating behaviour | Binge eating behaviour using a validated questionnaire | Three years | |
Secondary | Adverse health events | Adverse health events including the need for re-operation and cross over between interventions | Three years | |
Secondary | Resolution of co-morbidities | Resolution of co-morbidities at 3 years, including sleep apnoea, non alcoholic fatty liver disease, type-2 diabetes, hypertension and hyperlipidaemia. | Three years | |
Secondary | Time to resolution of co-morbidities | Time to resolution of sleep apnoea, type-2 diabetes, hypertension and hyperlipidaemia | Three years |
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