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1 L- versus 2 L-polyethylene glycol with ascorbic acid for bowel preparation in elderly patients: a randomized multicenter study

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Abstract

Background

1 L-polyethylene glycol (PEG)/ascorbic acid (Asc) was developed to reduce the required oral preparation volume through increasing osmotic load through containing a greater quantity of ascorbate components. We aimed to compare the efficacy, tolerability, and safety of a split-dosing regimen of 1 L-PEG/Asc versus 2 L-PEG/Asc in elderly patients undergoing scheduled colonoscopy.

Methods

This was a prospective, non-inferiority, randomized, investigator-blinded multicenter study conducted in Korea between July 2019 and December 2020. Patients aged between 65 and 85 years were randomized at a ratio of 1:1 to either the 1 L-PEG/Asc or 2 L-PEG/Asc group. The efficacy of the bowel preparation was evaluated using the Harefield Cleansing Scale (HCS) and the Boston Bowel Preparation Scale (BBPS).

Results

A total of 202 patients were analyzed. Successful overall bowel preparation was similar between the 1 L-PEG/Asc and 2 L-PEG/Asc groups based on HCS (95.1% vs. 93.1%, P = 0.528) and BBPS (93.1% vs. 90.0%, P = 0.422). The perfect overall bowel preparation rate in the 1 L-PEG/Asc group was higher than that in the 2 L-PEG/Asc group (HCS, 40.2% vs. 25.0%, P = 0.021; BBPS, 80.4% vs. 68.0%, P = 0.044). There were more high-quality bowel preparations for the right colon in the 1 L-PEG/Asc group (HCS, 46.1% vs. 30.0%, P = 0.019; BBPS, 83.3% vs. 70.0%, P = 0.025). The adenoma detection rate (47.1% vs. 49.0%, P = 0.782), rate of adverse events (25.5% vs. 23.0%, P = 0.680), shifts in laboratory results, and tolerability were comparable between the groups.

Conclusion

1 L-PEG/Asc was as effective, safe, and tolerable as 2 L-PEG/Asc in elderly patients with comorbidities.

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Funding

Study drug for bowel preparation and cost for colonoscopy were provided by Taejoon Pharm Co., Ltd., Korea. However, this study was initiated and carried out by the investigators, independently from the company.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea

    Jin Young Yoon, Ha Il Kim & Jae Myung Cha

  2. Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea

    Hyun Gun Kim

  3. Division of Gastroenterology, Department of Internal Medicine, Catholic University College of Medicine, Seoul, Korea

    Young Seok Cho

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  1. Jin Young Yoon
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Correspondence to Jae Myung Cha.

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Jin Young Yoon, Hyun Gun Kim, Young Seok Cho, Ha Il Kim, and Jae Myung Cha have no conflicts of interest or financial ties to disclose.

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Yoon, J.Y., Kim, H.G., Cho, Y.S. et al. 1 L- versus 2 L-polyethylene glycol with ascorbic acid for bowel preparation in elderly patients: a randomized multicenter study. Surg Endosc 36, 5724–5733 (2022). https://doi.org/10.1007/s00464-021-08947-4

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  • DOI: https://doi.org/10.1007/s00464-021-08947-4

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