Improved high-quality colon cleansing with 1L NER1006 versus 2L polyethylene glycol + ascorbate or oral sulfate solution.


Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
12 2019
Historique:
received: 10 05 2019
revised: 26 06 2019
accepted: 30 06 2019
pubmed: 15 8 2019
medline: 22 5 2020
entrez: 15 8 2019
Statut: ppublish

Résumé

Colonoscopy requires bowel cleansing for gut mucosa visualization; high-quality cleansing facilitates lesion detection. NER1006 is a 1L polyethylene glycol (PEG) bowel preparation. This post hoc analysis of two randomized trials investigated cleansing efficacy assessed, as in clinical practice, by site endoscopists. Patients received NER1006, 2L PEG + ascorbate (2LPEG), or oral sulfate solution (OSS) as a 2-day evening/morning regimen (N2D) or NER1006 morning-only dosing (N1D). Treatment-blinded site endoscopists assessed cleansing using the Harefield Cleansing Scale (HCS). Analyses were conducted in a modified full analysis set, including (mFAS; n = 1378) or excluding (mFAS2; n = 1319) imputed failures, and in patients with 100% treatment adherence (mFAS100; n = 1047). Overall cleansing success (HCS grade A/B), overall high-quality cleansing (HCS grade A), and high-quality segments (HCS 3-4) per treatment population were analyzed. Overall cleansing success was higher with N2D than 2LPEG (92.7-97.5% vs. 87.9-93.0%), and more patients had overall high-quality cleansing with N2D and N1D than 2LPEG (68.0-72.1% and 64.0-68.4% vs. 50.7-56.0%). Without imputed failures, N2D delivered more overall high-quality cleansing than OSS (74.5-77.3% vs. 67.8-69.8%). More high-quality segments were demonstrated with N2D and N1D versus 2 LPEG (82.5-87.1% and 79.4-84.4% vs. 70.4-76.3%) and with N2D versus OSS (82.7-89.5% vs. 78.1-84.4%). When assessed by site endoscopists, NER1006 delivers greater high-quality cleansing than 2LPEG or OSS.

Sections du résumé

BACKGROUND & AIMS
Colonoscopy requires bowel cleansing for gut mucosa visualization; high-quality cleansing facilitates lesion detection. NER1006 is a 1L polyethylene glycol (PEG) bowel preparation. This post hoc analysis of two randomized trials investigated cleansing efficacy assessed, as in clinical practice, by site endoscopists.
METHODS
Patients received NER1006, 2L PEG + ascorbate (2LPEG), or oral sulfate solution (OSS) as a 2-day evening/morning regimen (N2D) or NER1006 morning-only dosing (N1D). Treatment-blinded site endoscopists assessed cleansing using the Harefield Cleansing Scale (HCS). Analyses were conducted in a modified full analysis set, including (mFAS; n = 1378) or excluding (mFAS2; n = 1319) imputed failures, and in patients with 100% treatment adherence (mFAS100; n = 1047). Overall cleansing success (HCS grade A/B), overall high-quality cleansing (HCS grade A), and high-quality segments (HCS 3-4) per treatment population were analyzed.
RESULTS
Overall cleansing success was higher with N2D than 2LPEG (92.7-97.5% vs. 87.9-93.0%), and more patients had overall high-quality cleansing with N2D and N1D than 2LPEG (68.0-72.1% and 64.0-68.4% vs. 50.7-56.0%). Without imputed failures, N2D delivered more overall high-quality cleansing than OSS (74.5-77.3% vs. 67.8-69.8%). More high-quality segments were demonstrated with N2D and N1D versus 2 LPEG (82.5-87.1% and 79.4-84.4% vs. 70.4-76.3%) and with N2D versus OSS (82.7-89.5% vs. 78.1-84.4%).
CONCLUSION
When assessed by site endoscopists, NER1006 delivers greater high-quality cleansing than 2LPEG or OSS.

Identifiants

pubmed: 31409579
pii: S1590-8658(19)30684-X
doi: 10.1016/j.dld.2019.06.026
pii:
doi:

Substances chimiques

Cathartics 0
Sulfates 0
Polyethylene Glycols 3WJQ0SDW1A
Ascorbic Acid PQ6CK8PD0R

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

1671-1677

Informations de copyright

Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

Alessandro Repici (A)

Humanitas University, Milan, Italy.

Emmanuel Coron (E)

Centre Hospitalier Universitaire Hotel Dieu, Nantes, France.

Prateek Sharma (P)

Department of Gastroenterology and Hepatology, Veterans Affairs Medical Center, Kansas City, MO, USA; Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, KS, USA.

Cristiano Spada (C)

Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.

Milena Di Leo (M)

Humanitas University, Milan, Italy.

Colin L Noble (CL)

Western General Hospital, Edinburgh, UK.

Jürgen Gschossmann (J)

Klinikum Forchheim, Forchheim, Germany.

Ana Bargalló García (A)

Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Spain; Endos Medicina, Barcelona, Spain.

Daniel C Baumgart (DC)

Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada. Electronic address: baumgart@ualberta.ca.

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Classifications MeSH