1-L polyethylene glycol + ascorbic acid versus sodium picosulfate + magnesium citrate bowel preparations for colonoscopy: effectiveness and safety

• Elena Pérez Arellano ^[1] ; M.ª Isabel Rodríguez García ^[1] ; Ana Belén Galera Ródenas ^[1] ; Álvaro Flores de Miguel ^[1] ; Emilio de la Morena Madrigal ^[1]
  1. [1] Hospital La Zarzuela

     Hospital La Zarzuela

     Madrid, España

     
• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 116, Nº. 4, 2024, págs. 186-192
• Idioma: inglés
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• Resumen

  • Background: adequate bowel preparation is crucial for the protective effect of colonoscopy. Commonly used prepa- ration regimens like polyethylene glycol (PEG) or sodium picosulfate with magnesium citrate (SPMC) have shown similar results in clinical trials, but low-volume PEG + ascor- bic acid (1-L PEG + ASC) versus SPMC have never been com- pared in a real-life setting.

    Aim: to evaluate the effectiveness and safety of 1-L PEG + ASC versus SPMC in a real-life setting for the overall pop- ulation, for patients aged ≥ 65 years, and males versus fe- males.

    Methods: out-patients aged ≥ 18 years who underwent colonoscopy for any indication were randomly assigned to the 1-L PEG + ASC or SPMC group. Using the Boston Bowel Preparation Scale (BBPS), the primary endpoints were the bowel cleansing success of the overall colon and right co- lon, as well as high-quality (HQ) cleansing. Furthermore, the effectiveness and safety outcomes for age groups and males versus females were compared.

    Results: 1-L PEG + ASC showed significantly better bowel cleansing success than SPMC. Particularly remarkable is the HQ cleansing reached with 1-L PEG + ASC compared with SPMC (55.5 % versus 25.4 % in the overall colon, and 58.7 % versus 27.2 % in the right colon). 1-L PEG + ASC was equally effective for men and women while SPMC showed significant differences between genders (men had worse bowel cleansing). Age did not affect the cleansing effectiveness. 1-L PEG + ASC versus SPMC showed significant differences in tolerance and safety;

    women also had significantly worse tolerance than men for both solutions, but these did not affect the quality of bowel cleansing.

    Conclusions: in our real-life setting, 1-L PEG + ASC offered better adequate and HQ bowel cleansing than SPMC, achieving excellent cleansing quality, regardless of gender or tolerance.