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

Maida, Marcello; Morreale, Gaetano Cristian; Sferrazza, Sandro; Sinagra, Emanuele; Scalisi, Giuseppe; Vitello, Alessandro; Vettori, G; Rossi, Francesca; Catarella, Domenico; Bartolo, C.E. Di; Schillaci, D.; Raimondo, Dario; Camilleri, S.; Orlando, Ambrogio; Macaluso, Fabio Salvatore

doi:10.1016/j.dld.2021.04.006

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…In a 2021 retrospective analysis of a prospective cohort, Maida et al [ 107 ] demonstrated the efficacy and safety of 1-L PEG-ASC in 45% of 411 patients.…”

Section: Specific Clinical Settingsmentioning

confidence: 99%

“…IBD patients had higher cleansing success (92.9% vs 85.4%, P = 0.02) than controls, with a similar number of patients experiencing adverse events (22.2% vs 21.2%, P = 0.821) and treatment-emergent adverse events (51 vs 62%, P = 0.821). Furthermore, the presence of IBD (OR = 2.51, P = 0.019), lower age (OR = 0.98, P = 0.014), a split regimen (OR = 2.43, P = 0.033), the absence of diabetes (OR = 2.85, P = 0.015), and chronic constipation (OR = 3.35, P = 0.005) were all independently associated with cleansing success[ 107 ].…”

Section: Specific Clinical Settingsmentioning

confidence: 99%

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Factors affecting the quality of bowel preparation for colonoscopy in hard-to-prepare patients: Evidence from the literature

Shahini¹,

Sinagra²,

Vitello³

et al. 2023

World J Gastroenterol

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Adequate bowel cleansing is critical for a high-quality colonoscopy because it affects diagnostic accuracy and adenoma detection. Nevertheless, almost a quarter of procedures are still carried out with suboptimal preparation, resulting in longer procedure times, higher risk of complications, and higher likelihood of missing lesions. Current guidelines recommend high-volume or low-volume polyethylene glycol (PEG)/non-PEG-based split-dose regimens. In patients who have had insufficient bowel cleansing, the colonoscopy should be repeated the same day or the next day with additional bowel cleansing as a salvage option. A strategy that includes a prolonged low-fiber diet, a split preparation regimen, and a colonoscopy within 5 h of the end of preparation may increase cleansing success rates in the elderly. Furthermore, even though no specific product is specifically recommended in the other cases for difficult-to-prepare patients, clinical evidence suggests that 1-L PEG plus ascorbic acid preparation are associated with higher cleansing success in hospitalized and inflammatory bowel disease patients. Patients with severe renal insufficiency (creatinine clearance < 30 mL/min) should be prepared with isotonic high volume PEG solutions. Few data on cirrhotic patients are currently available, and no trials have been conducted in this population. An accurate characterization of procedural and patient variables may lead to a more personalized approach to bowel preparation, especially in patients undergoing resection of left colon lesions, where intestinal preparation has a poor outcome. The purpose of this review was to summarize the evidence on the risk factors influencing the quality of bowel cleansing in difficult-to-prepare patients, as well as strategies to improve colonoscopy preparation in these patients.

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“…In a 2021 retrospective analysis of a prospective cohort, Maida et al [ 107 ] demonstrated the efficacy and safety of 1-L PEG-ASC in 45% of 411 patients.…”

Section: Specific Clinical Settingsmentioning

confidence: 99%

Section: Specific Clinical Settingsmentioning

confidence: 99%

Factors affecting the quality of bowel preparation for colonoscopy in hard-to-prepare patients: Evidence from the literature

Shahini¹,

Sinagra²,

Vitello³

et al. 2023

World J Gastroenterol

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“…FAC is an inflammatory pattern that may or may not be clinically relevant. It is most observed in adult patients with bowel preparation artifacts [9,10,[29][30][31][32][33], infectious colitis, drug-induced gastrointestinal injuries, and IBS. Less frequently, it may manifest as IBD [34,35], such as CD or partially treated UC.…”

Section: Discussionmentioning

confidence: 99%

Focal Active Colitis: What Are Its Clinical Implications? A Narrative Review

Sinagra,

Mandarino,

Maida

et al. 2023

Biomedicines

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Focal active colitis (FAC) is described as a histolopathological term indicating the isolated finding of focal neutrophil infiltration in the colonic crypts. Currently, there exist numerous debates regarding the clinical significance of diagnosing FAC, which may or may not have clinical relevance as it is frequently detected in colorectal biopsies without any other microscopic abnormalities. The objective of this narrative review is to provide an overview of the available evidence concerning the clinical implications of FAC, both in the adult population (among five studies available in the scientific literature) and in the pediatric context (based on two available studies).

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“…Therefore, the final dropout rate was increased to 5.46% 33,34 the authors have limited experience on 1-L PEG-Asc for aged patients or patients with chronic disorders. With the safety concerns, aged patients and patients with chronic disorders were excluded from this study.…”

mentioning

confidence: 99%

Comparison of Two Types of 1-L Polyethylene Glycol-ascorbic Acid as Colonoscopic Bowel Preparation: A Prospective Randomized Study

Choi

Yoon

Kim

et al. 2022

Korean J Gastroenterol

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Background/Aims: Recently, 1-L polyethylene glycol-ascorbic acid (PEG-Asc) has been used to reduce the volume of preparation agents in colonoscopy. This clinical trial aimed to compare the efficacy and safety of two types of 1-L PEG-Asc (CleanViewAL ® [Tae Joon Pharmaceutical Company, Seoul, Korea] and Plenvu ® [Norgine, Harefield, United Kingdom]) in average-aged adults. Methods: This study was a prospective, randomized, non-inferiority, open-label, phase 4 clinical trial. The primary endpoint was the efficacy evaluated using the Boston bowel preparation scale (BBPS), and the secondary endpoint was clinical safety. Results: In total, 173 patients were assigned to either the CleanViewAL ® (n=84) or Plenvu ® (n=89) group. Overall cleansing successes of 97.6% (82/84) and 98.8% (88/89) were achieved in the CleanViewAL ® group and in the Plenvu ® group, respectively, showing that CleanViewAL ® has similar bowel cleansing efficacy to Plenvu ® (95% CI, -0.052 to 0.027; p=0.207). The total BBPS score was 8.67±1.00 and 8.70±0.76 in the CleanViewAL ® group and Plenvu ® group, respectively (p=0.869). The most common adverse symptom was nausea, and no adverse symptoms requiring hospitalization were reported in either group. There were no cases of critical hypernatremia and liver dysfunction exceeding the common terminology criteria for adverse events grade I. An overall satisfaction score (scale of 1 to 10) showed no difference between the two groups (p=0.289). However, the CleanViewAL ® group showed a higher taste satisfaction score (scale of 1 to 5) than the Plenvu ® group (CleanViewAL ® : 2.90±0.91, Plenvu ® : 2.60±0.86, p=0.028). Conclusions: Both types of 1-L PEG-Asc, CleanViewAL ® and Plenvu ® , are effective and safe bowel cleansing agents in average-aged adults. CleanViewAL ® was preferred in terms of taste satisfaction.

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

Cited by 6 publications

References 21 publications

Factors affecting the quality of bowel preparation for colonoscopy in hard-to-prepare patients: Evidence from the literature

Factors affecting the quality of bowel preparation for colonoscopy in hard-to-prepare patients: Evidence from the literature

Focal Active Colitis: What Are Its Clinical Implications? A Narrative Review

Comparison of Two Types of 1-L Polyethylene Glycol-ascorbic Acid as Colonoscopic Bowel Preparation: A Prospective Randomized Study

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