A randomized clinical prospective trial comparing split-dose picosulfate/ magnesium citrate and polyethylene glycol for colonoscopy preparation

• Published in: PloS one 2019-03, Vol.14 (3), p.e0211136-e0211136
• Main Authors: Rostom, Alaa, Dube, Catherine, Bishay, Kirles, Antonova, Lilia, Heitman, Steven J, Hilsden, Robert
• Format: Article
• Language: English
• Subjects: Abnormalities; Adult; Aged; Aged, 80 and over; Biology and Life Sciences; Cancer; Cancer screening; Citrates - therapeutic use; Citric acid; Citric Acid - therapeutic use; Colon; Colon - physiology; Colon cancer; Colonoscopy; Colonoscopy - methods; Colorectal cancer; Control methods; Dosage; Drug dosages; Early Detection of Cancer - methods; Electrolytes; Ethylene glycols; Factor analysis; Female; Gastroenterology; Glycols (Class of compounds); Health aspects; Health sciences; Heart failure; Humans; Intestine; Lavage; Magnesium; Magnesium citrate; Male; Medical screening; Medicine; Medicine and Health Sciences; Middle Aged; Mortality; Organometallic Compounds - therapeutic use; Patient Compliance; Patients; Physical Sciences; Picolines - therapeutic use; Polyethylene glycol; Polyethylene Glycols - therapeutic use; Polyols; Quality; Randomization; Sodium picosulfate; Surveillance; Systematic review; Therapeutic Irrigation - methods; Tumors; Variance analysis
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0211136

Colonoscopy remains the gold standard for the investigation of abnormalities within the colon. However, its success is highly dependent on the quality of bowel preparation. The objective of this study was to compare the bowel preparation efficacy of picosulfate/magnesium citrate (PMC) vs polyethylene glycol (PEG) in a one-day vs two-day split dose regimen. A prospective, randomized, controlled trial was conducted at the Forzani & MacPhail Colon Cancer Screening Centre in Calgary, Canada. 171 colonoscopy outpatients were randomized to split-dose PMC or PEG lavage as well as into one-day split or two-day split regimens in blocks of eight. Bowel preparation quality was recorded in a blinded manner by the endoscopist using the Ottawa Bowel Preparation Scale (OBPS) prior to washing or suctioning. The scale results were analyzed using a two-factor analysis of variance. 141 patients received complete colonoscopies (PMC-71; PEG-70). PEG was found to be superior to PMC (mean OBPS: 4.14 ± 2.64 vs 5.11 ± 3.44, p = 0.019), when adjusted for administration regimen, leading to significantly more adequate bowel preparations (79.7% vs 59.7%, p = 0.007). A two-day split dose was superior to a one-day split dose regimen (mean OBPS: 3.68± 2.82 vs 5.69 ± 3.06, p