Effectiveness and safety of 1L PEG-ASC preparation for colonoscopy in patients with inflammatory bowel diseases

• Published in: Digestive and liver disease 2021-09, Vol.53 (9), p.1171-1177
• Main Authors: Maida, M., Morreale, G.C., Sferrazza, S., Sinagra, E., Scalisi, G., Vitello, A., Vettori, G., Rossi, F., Catarella, D., Di Bartolo, C.E., Schillaci, D., Raimondo, D., Camilleri, S., Orlando, A., Macaluso, F.S.
• Format: Article
• Language: English
• Subjects: Adult; Ascorbic Acid - administration & dosage; Ascorbic Acid - adverse effects; Ascorbic Acid - analogs & derivatives; Bowel preparation; Cathartics - administration & dosage; Cathartics - adverse effects; Colitis, Ulcerative - complications; Colonoscopy; Colonoscopy - methods; Crohn Disease - complications; Effectiveness; Female; Humans; Inflammatory bowel diseases; Male; Middle Aged; PEG; Phosphatidylethanolamines - administration & dosage; Phosphatidylethanolamines - adverse effects; Retrospective Studies
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2021.04.006

The effectiveness of bowel cleansing is a key element for high-quality colonoscopy. Recently, a 1 L polyethylene glycol plus ascorbate (PEG-ASC) solution has been introduced, but effectiveness and safety of this preparation have not been assessed in IBD patients. This study aims to evaluate effectiveness and safety of 1 L PEG-ASC solution in patients with IBD compared to controls. We retrospectively analysed prospectively collected data on a cohort of 411 patients performing a colonoscopy after preparation with 1 L PEG-ASC, consecutively enrolled in 5 Italian centres. Overall, 185/411 (45%) were patients with IBD and 226/411 (55%) served as controls. A significantly higher cleansing success was achieved in IBD patients (92.9% vs 85.4%, p = 0.02). The multiple regression model showed that presence of IBD (OR=2.514, 95%CI=1.165–5.426; P = 0.019), lower age (OR=0.981, 95%CI=0.967–0.996; P = 0.014), split preparation (OR=2.430, 95%CI=1.076–5.492; P = 0.033), absence of diabetes (OR=2.848, 95%CI=1.228–6.605; P = 0.015), and of chronic constipation (OR=3.350, 95%CI=1.429–7.852; P = 0.005), were independently associated with cleansing success. The number of treatment-emergent adverse events (TEAEs) (51 vs 62%, p = 0.821), and of patients with TEAEs (22.2% vs 21.2%, p = 0.821), were similar in IBD patients and in controls, respectively. Results from this study support the effectiveness and safety of 1 L PEG-ASC solution in IBD patients, which may improve the definition of endoscopic outcomes both in Crohn’s disease and ulcerative colitis.