Sodium Picosulfate with Magnesium Citrate (SPMC) Plus Laxative Is a Good Alternative to Conventional Large Volume Polyethylene Glycol in Bowel Preparation: A Multicenter Randomized Single-Blinded Trial

Hyun Gun Kim, Kyu Chan Huh, Hoon Sup Koo, Seong-Eun Kim, Jin-Oh Kim, Tae Il Kim, Hyun-Soo Kim, Seung-Jae Myung, Dong Il Park, Jeong Eun Shin, Dong-Hoon Yang, Suck-Ho Lee, Ji Sung Lee, Chang Kyun Lee, Dong Kyung Chang, Young-Eun Joo, Jae Myung Cha, Sung Pil Hong, Hyo Jong Kim, Hyun Gun Kim, Kyu Chan Huh, Hoon Sup Koo, Seong-Eun Kim, Jin-Oh Kim, Tae Il Kim, Hyun-Soo Kim, Seung-Jae Myung, Dong Il Park, Jeong Eun Shin, Dong-Hoon Yang, Suck-Ho Lee, Ji Sung Lee, Chang Kyun Lee, Dong Kyung Chang, Young-Eun Joo, Jae Myung Cha, Sung Pil Hong, Hyo Jong Kim

Abstract

Background/aims: We investigated whether sodium picosulfate with magnesium citrate (SPMC) plus bisacodyl compares favorably with conventional polyethylene glycol (PEG) with respect to bowel cleansing adequacy, compliance, and safety.

Methods: We performed a multicenter, prospective, single-blinded study in outpatients undergoing daytime colonoscopies. Patients were randomized into a split preparation SPMC/bisacodyl group and a conventional split PEG group. We compared preparation adequacy using the Boston bowel preparation scale (BBPS), ease of use using a modified Likert scale (LS), compliance/satisfaction level using a visual analogue scale (VAS), and safety by monitoring adverse events during the colonoscopy between the two groups.

Results: A total of 365 patients were evaluated by intention to treat (ITT) analysis, and 319 were evaluated by per protocol (PP) population analysis (153 for SPMC/bisacodyl, 166 for PEG). The mean total BBPS score was not different between the two groups in both the ITT and PP analyses (p>0.05). The mean VAS score for satisfaction and LS score for the ease of use were higher in the SPMC/bisacodyl group (p<0.001). The adverse event rate was lower in the SPMC/bisacodyl group than in the PEG group (p<0.05).

Conclusions: The SPMC/bisacodyl treatment was comparable to conventional PEG with respect to bowel preparation adequacy and superior with respect to compliance, satisfaction, and safety.

Keywords: Bowel preparation; Colonoscopy; Polyethylene glycols; Sodium picosulfate with magnesium citrate.

Figures

Fig. 1
Fig. 1
The Boston bowel preparation scale (BBPS) score percentage of each colon segment with sodium picosulfate with magnesium citrate (SPMC)/bisacodyl and conventional polyethylene glycol (PEG). (A) Intention to treat analysis. (B) Per protocol analysis.
Fig. 2
Fig. 2
Error bar plot of the visual analogue scale (VAS) score for each preparation group in the intention to treat (ITT) and per protocol (PP) populations. The mean VAS score of the sodium picosulfate with magnesium citrate (SPMC)/bisacodyl group was significantly greater than that of the conventional polyethylene glycol (PEG) group in both the ITT and PP analyses. CI, confidence interval.
Fig. 3
Fig. 3
Error bar plot of the modified Likert scale between the two preparation groups within the intention to treat (ITT) and per protocol (PP) populations. (A) Ease of use. The mean modified Likert scale score of the sodium picosulfate with magnesium citrate (SPMC)/bisacodyl group was significantly greater than that of the conventional polyethylene glycol (PEG) group in both the ITT and PP analyses. (B) Taste. The mean modified Likert scale score of the SPMC/bisacodyl group was significantly greater than that of the conventional PEG group in both the ITT and PP analyses. CI, confidence interval.

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Source: PubMed

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