A randomized trial to compare the efficacy and tolerability of sodium picosulfate-magnesium citrate solution vs. 4 L polyethylene glycol solution as a bowel preparation for colonoscopy

• Published in: International journal of colorectal disease Vol. 30; no. 10; pp. 1407 - 1416
• Main Authors: Muñoz-Navas, Miguel, Calleja, José Luis, Payeras, Guillermo, Hervás, Antonio José, Abreu, Luis Esteban, Orive, Víctor, Menchén, Pedro L., Bordas, José María, Armengol, José Ramón, Carretero, Cristina, Beltrán, Vicente Pons, Alonso-Abreu, Inmaculada, Manteca, Román, Parra-Blanco, Adolfo, Carballo, Fernando, Herrerías, Juan Manuel, Badiola, Carlos
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2015; Springer; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Cathartics - administration & dosage; Cathartics - adverse effects; Citrates - administration & dosage; Citrates - adverse effects; Citric Acid - administration & dosage; Citric Acid - adverse effects; Colonoscopy; Colonoscopy - methods; Drug Administration Schedule; Female; Gastroenterology; Gastrointestinal Diseases - chemically induced; Hepatology; Humans; Internal Medicine; Magnesium citrate; Male; Medicine; Medicine & Public Health; Middle Aged; Organometallic Compounds - administration & dosage; Organometallic Compounds - adverse effects; Original Article; Patient Satisfaction; Picolines - administration & dosage; Picolines - adverse effects; Polyethylene glycol; Polyethylene Glycols - administration & dosage; Polyethylene Glycols - adverse effects; Proctology; Surgery; Young Adult; Bowel cleansing colonoscopy; Same-day bowel preparation; Randomized trial; Sodium picosulfate/magnesium citrate; Polyethylene glycol
• DOI: 10.1007/s00384-015-2307-6
• ISSN: 0179-1958

Purpose The purpose of this study is to compare the efficacy and acceptability of an evening-before regimens of sodium picosulfate/magnesium citrate (SPMC) and polyethylene glycol (PEG) as bowel cleansers and to explore the results of a same-day regimen of SPMC. Methods Multicenter, randomized, observer-blinded, parallel study carried out in subjects who were 18–80 years old and were undergoing diagnostic colonoscopy for the first time. The primary outcome was treatment success, which was a composite outcome defined by (1) the evaluation of the overall preparation quality as “excellent” or “good” by two blinded independent evaluators with the Fleet® Grading Scale for Bowel Cleansing and (2) a subject’s acceptability rating of “easy to take” or “tolerable.” The primary outcome was analyzed using a logistic regression with site, gender, and age group (age ≥65 years and <65 years) as factors. Results Four hundred ninety subjects were included in the efficacy evaluation. Although treatment success was significantly higher in subjects assigned to the evening-before regimen of SPMC vs. subjects assigned to the evening-before PEG, when evaluating the two individual components for treatment success, there were significant differences in the ease of completion but not in the quality of preparation. The same-day SPMC regimen was superior to both the evening-before regimen of SPMC and PEG in terms of the quality of preparation, especially regarding the proximal colon. Conclusions An evening-before regimen of SPMC is superior to an evening-before regimen of PEG in terms of subject’s acceptability. The same-day SPMC regimen provides better cleansing levels in the proximal colon.