POLYETHYLENE GLYCOL: DECREASING THE VOLUME DOES NOT COMPROMISE EFFECTIVENESS!

Aims Success of colonoscopy is linked to the adequacy of bowel cleansing. Polyethylene glycol (PEG) solutions are widely used for colonic cleansing but with limitations concerning tolerability and acceptability. Plenvu is the first PEG-containing bowel preparation that requires only 1L of water for dissolution and ingestion.

The aim of this study was to compare the efficacy of two low volume PEG preparations: Plenvu-1L versus Moviprep-2L. Secondary endpoint was to compare the patient’s satisfaction with the two bowel preparation regimens based on a validated questionnaire performed on the day of the colonoscopy that evaluated the tolerability and the occurrence of adverse effects.

Methods Single-center, prospective, randomized, blinded study. Patients received either Plenvu-1L or Moviprep-2L (1:1).

Results After exclusion criteria, 449 patients were included, median age 59 (18-86) years, 52.3% male, 50.3% (n=226) received Plenvu and 49.7% (n=223) Moviprep. Both groups were homogeneous regarding age, gender, co-morbidities and medication.

There were no differences between the groups regarding the rate of adequate bowel preparation (Boston Bowel Preparation Scale [BBPS] ≥6, with no subscore less than 2) (88.1%vs83%; p=0.125); Although there was a trend towards the Plenvu group presenting more frequently with excellent preparation (BBPS 8-9), it did not reach statistical significance (60.6%vs51.6%;p=0.053).

Moreover, patients on Plenvu group classified the flavor of the preparation as unpleasant more frequently (49.1%vs32.3%;p< 0.001) and presented more frequently with nausea (43.8%vs32.3%;p=0.012) or vomit (20.4%vs11.2%;p=0.008). Although nearly half of patients found the preparation unpleasant, none discontinued, and the overall cleansing success was still achieved in these patients.

Conclusions Patients on Plenvu group presented more frequently an excellent quality of preparation compared to patients on Moviprep however, not statistically significant. High-quality cleansing may become performance target for pre-colonoscopy bowel preparation over other quality measures. Plenvu group reported more frequently unpleasant flavor and more adverse events (nausea and vomiting) but achieved overall cleansing success.