Efficacy of 1 L polyethylene glycol plus ascorbate versus 4 L polyethylene glycol in split-dose for colonoscopy cleansing in out and inpatient: A multicentre, randomized trial (OVER 2019). in Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver / Dig Liver Dis. 2024 Mar;56(3):495-501. doi: 10.1016/j.dld.2023.07.032. Epub 2023 Aug 12.

2024
AOU Novara

Tipo pubblicazione

Randomized Controlled Trial

Autori/Collaboratori (24)Vedi tutti...

Melita G
AOU G. Martino, Messina, Italy.
Scalisi G
Nesima-Garibaldi Hospital, Catania, Italy.
Rancatore G
AOU Policlinico Paolo Giaccone, Palermo, Italy.

et alii...

Abstract

BACKGROUND AND AIMS: Adequate bowel cleansing is essential for colonoscopy quality. A novel 1 L polyethylene glycol plus ascorbate (1 L PEG+ASC) solution has been recently introduced. Nevertheless, the efficacy of 1 L PEG+ASC as compared to that of high-volume bowel preparation in both inpatients and outpatients is still unclear. PATIENTS AND METHODS: This single-blinded, non-inferiority study randomized patients undergoing colonoscopy to receive split-dose 1 L PEG+ASC or 4 L PEG. The primary endpoint was the overall cleansing success. Secondary endpoints were excellent cleansing and high-quality cleansing of the right colon, as well as lesions detection rate, patient compliance, tolerability and safety. RESULTS: Overall, 478 patients were randomized to 1 L PEG+ASC (N = 236) or 4 L PEG (N = 242). The 1 L PEG+ASC showed higher cleansing success rate (91.8% vs 83.6%; P=0.01) and a high-quality cleansing of the right colon (52.3% and 38.5%; P=0.004) compared to 4 L PEG. Moreover, 1 L PEG+ASC achieved a higher cleansing success in out-patients (96.3%% vs 88.6%; P=0.018), and a similar success rate in the in-patients (84.7% vs 76.7%; P=0.18). Adenoma detection rate, tolerability and incidence of adverse events were comparable between preparations. CONCLUSIONS: The 1 L PEG+ASC showed higher efficacy in achieving adequate colon cleansing compared with 4 L PEG, particularly in the right colon. No differences in the tolerability and safety were detected.

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PMID : 37574430

DOI : 10.1016/j.dld.2023.07.032

Keywords

Cathartics/adverse effects; Polyethylene Glycols/adverse effects; Humans; Colonoscopy; Laxatives; Colon; Ascorbic Acid/adverse effects; Bowel preparation; Colonoscopy; Colorectal cancer; Effectiveness; Polyethylene glycol;