The Bowel CLEANsing National Initiative: A Low-Volume Same-Day Polyethylene Glycol (PEG) Preparation vs Low-Volume Split-Dose PEG With Bisacodyl or High-Volume Split-Dose PEG Preparations-A Randomized Controlled Trial.


Journal

The American journal of gastroenterology
ISSN: 1572-0241
Titre abrégé: Am J Gastroenterol
Pays: United States
ID NLM: 0421030

Informations de publication

Date de publication:
12 2020
Historique:
pubmed: 3 8 2020
medline: 5 1 2021
entrez: 3 8 2020
Statut: ppublish

Résumé

Bowel cleanliness has been shown to be superior with split-dose vs nonsplit preparations; we aimed to directly assess the poorly characterized comparative efficacies of split-dose vs same-day polyethylene glycol (PEG) regimens. In this study, one of a series of randomized trials performed across 10 Canadian endoscopy units, patients undergoing colonoscopies between 10:30 and 16:30 were allocated to PEG low-volume same-day (15 mg bisacodyl the day before, 2 L the morning of the procedure), low-volume split-dose (15 mg bisacodyl the day before, 1 L + 1 L), or high-volume split-dose (2 L + 2 L). Coprimary endpoints were adequate bowel cleansing based on the Boston Bowel Preparation Scale using in turn different threshold cutoffs. Overall, 1,750 subjects were randomized equally across the 3 groups, with no differences in adequate bowel cleanliness rates (low-volume same-day, 90.5%; high-volume split-dose, 92.2%; P = 0.34; and low-volume split-dose, 87.9%; P = 0.17) for the Boston Bowel Preparation Scale ≥6 and 2 for each segment. Willingness to repeat the preparation was not significantly different between low-volume same-day (91.0%) and low-volume split-dose (92.5%; P = 0.40) but was greater than the high-volume split-dose (68.9%; P < 0.01). No significant differences were noted for withdrawal time, cecal intubation, or polyp detection rates. In this large randomized trial of PEG regimens, low-volume same-day resulted in similar bowel cleanliness compared with high-volume or low-volume split-dosing. Willingness to repeat and tolerability were superior with low-volume same-day compared with high-volume split-dose and similar to low-volume split-dose.

Identifiants

pubmed: 32740079
doi: 10.14309/ajg.0000000000000760
pii: 00000434-202012000-00026
doi:

Substances chimiques

Cathartics 0
Bisacodyl 10X0709Y6I
Polyethylene Glycols 3WJQ0SDW1A

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2068-2076

Commentaires et corrections

Type : CommentIn

Références

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Auteurs

Alan N Barkun (AN)

McGill University Health Center, McGill University, Montreal, Québec, Canada.

Myriam Martel (M)

McGill University Health Center, McGill University, Montreal, Québec, Canada.

Ian L Epstein (IL)

Dalhousie University, Halifax, Nova Scotia, Canada.

Pierre Hallé (P)

Hôpital du Saint-Sacrement, Québec, Québec, Canada.

Robert J Hilsden (RJ)

University of Calgary, Calgary, Alberta, Canada.

Paul D James (PD)

University Health Network, Toronto, Ontario, Canada.

Alaa Rostom (A)

University of Ottawa, Ottawa, Ontario, Canada.

Michael Sey (M)

Western University, London, Ontario, Canada.

Harminder Singh (H)

University of Manitoba, Winnipeg, Manitoba, Canada.

Richard Sultanian (R)

Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada.

Jennifer J Telford (JJ)

University of British Columbia, Vancouver, British Columbia, Canada.

Daniel von Renteln (D)

Université de Montréal, Montreal, Quebec, Canada.

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