Effectiveness and safety of a 1-L polyethylene glycol and ascorbic acid preparation for colonoscopy in routine clinical practice in Spain.

Abstract

Background and aims: large clinical trials and small real-world studies show that a 1-L polyethylene glycol and ascorbic acid solution (1-L PEG-ASC) is an effective and safe bowel preparation for colonoscopy. Here, the effectiveness and safety of 1-L PEG-ASC was evaluated in a large cohort of patients in routine clinical practice in Spain.

Methods: a sub-analysis was performed in an observational, multicenter, retrospective study assessing the effectiveness and safety of 1-L PEG-ASC in adult patients undergoing a colonoscopy at ten centers in Spain. Cleansing quality was assessed with the Boston Bowel Preparation Scale, scores ≥ 6 with all segmental scores ≥ 2 were considered as adequate colon cleansing, and high-quality was considered as cleansing ≥ 8 or = 3 in the right colon. Polyp and adenoma detection rates, and adverse events were also assessed.

Results: data were collected from 7,160 patients; 48.3 % were males, mean age was 58.0 and 33.6 % were ≥ 65 years old. Adequate overall bowel cleansing was achieved in 95.6 % of patients (95 % CI: 95.1-96.0 %), high quality cleansing in 74.4 % (95 % CI: 73.4-75.4 %) and high-quality right colon cleansing in 66.0 % (95 % CI: 64.9-67.1). The adequate overall cleansing rate was 97.0 % with a split-dose and 94.0 % with same-day regimen (p < 0.0001), and high-quality right colon cleansing was 69.0 % and 62.5 % (p < 0.0001), respectively. Colonoscopy was completed in 97.2 % of cases. A multivariate regression analysis revealed that an overnight split-dose regimen and age < 65 years were independent predictors of adequate bowel cleansing of the overall colon, age < 65 years and female gender were independent predictors of high quality (HQ) cleansing of the overall colon, and the three covariates were independent predictors of HQ cleansing of the right colon. At least one adverse event was experienced by 3.3 % of participants, with nausea (1.5 %) and vomiting (1.2 %) being the most frequent.

Conclusion: this sub-analysis confirmed 1-L PEG-ASC to be an effective and safe bowel cleansing preparation in a real world setting in Spain.