Treatment of Idiopathic Intracranial Hypertension: the IIH:WT community weight loss programme for the sustained A randomised controlled trial of bariatric surgery versus a community weight loss programme for the sustained treatment of Idiopathic Intracranial Hypertension.
Over 90% of patients with IIH are overweight and weight loss is the most effective treatment. Other treatments for IIH have very little current evidence to support their use. This trial aims to compare two methods of weight loss, bariatric surgery and the most effective dietary programme commonly available, Weight Watchers, to see which offers the most effective longterm treatment for IIH. Bariatric surgery is recommended by the NICE clinical guidelines for patients with a Body Mass Index (BMI) of over 40, or over 35 with a co-morbidity. Women suffering from IIH have a BMI on average around 38 and IIH is not recognised as a co-morbidity for bariatric surgery.Current therapy for IIH
The 2005 Cochrane review concluded that there was insufficient evidence to determine which treatments were potentially beneficial and which were harmful in IIH (3); hence there are no specific guidelines regarding the treatment of IIH.
Weight loss, achieved through intensive dieting, is an effective therapeutic strategy in IIH. However long-term maintenance of weight loss is notoriously poor, which leads to the recurrence of symptoms: patients in the IIH weight loss study were noted to regain weight and consequently their symptoms and signs of IIH relapsed, a documented phenomenon in the condition. Despite the relapse in IIH following weight gain, our study provides evidence of the efficacy of therapeutic weight loss. Consequently, sustainable approaches to weight loss in IIH are likely to offer patients an effective, potentially curative treatment. We wish to assess if sustained weight loss will result in sustained reduction of ICP, visual symptoms and headaches, and if bariatric surgery is a viable method of achieving this.
Trustees of IIH UK sit as the patient representative on the trial steering committee - please visit the IIH UK website for more information on this trial. In addition to determining if weight loss is an effective treatment for IIH, there are many sub studies being undertaken in this trial, which may well drive future IIH research. http://www.iih.org.uk/research