Non-inferiority between two low-volume agents (sodium picosulfate/magnesium citrate vs. sodium sulfate/potassium/magnesium) to prepare the bowel for diagnostic procedures: an observational study
DOI:
https://doi.org/10.22516/25007440.545Keywords:
Colorectal neplasia, sodium picosulphate, intestinal preparation, real life evidenceAbstract
Introduction: Colorectal cancer is a public health problem; however, early detection reduces morbidity
and mortality. Colonoscopy is the procedure of choice for detecting precancerous lesions, and success
depends on proper bowel cleansing.
Objective: To evaluate the performance of two low-volume agents used in a high-level hospital.
Materials and methods: Prospective study in adults who underwent colonoscopy at the Fundación Santa Fe in Bogotá, Colombia. Preparations were evaluated using the Boston Bowel Preparation Scale. A score ≥6 points indicated adequate preparation. A logistic regression analysis was carried out to establish the effectiveness of the medicines with a non-inferiority ratio of 3-5%.
Results: 598 patients were evaluated. 49% (293) received sodium picosulfate/magnesium citrate and 51% (305) received sodium sulfate/potassium/magnesium, with an average Boston score of 6.98±1.86 (78% Boston ≥6) and 7.39±1.83 (83%), respectively (p=0.649). According to the analysis of the presence and frequency of unwanted symptoms, picosulfate was better tolerated (p < 0.001).
Conclusions: Bowel preparation studies in patients from a real-life scenario are scarce. Low-volume
agents had similar overall and segmental effectiveness in the colon, confirming non-inferiority; sodium
picosulfate/magnesium citrate was better tolerated. A cost-effectiveness study could establish the best
option according to the needs of the study population.
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