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Efficacy, Tolerance and Safety of Split Dose Bowel Preparation for Colonoscopy: 4L Polyethylene Glycol (PEG) Versus 1L Polyethylene Glycol Plus Sodium Picosulfate-magnesium Citrate (SPMC)

Phase 4
Recruiting
Conditions
Bowel Preparation Solutions
Colonoscopy
Interventions
Drug: 4L Klean Prep®
Drug: 1L Klean prep® and 2 sachets Picoprep®
Registration Number
NCT04474002
Lead Sponsor
Queen Elizabeth Hospital, Hong Kong
Brief Summary

4L split dose PEG is the gold standard for bowel preparation, however it comes with poor tolerability and poor compliance. Combination of PEG with different agent is useful in reducing total volume, improving compliance and tolerance of patient.

The objective of this study is to demonstrate that combination bowel preparation, PEG plus SPMC solution, has similar efficacy and safety profile whereas with a better tolerance when compared to large volume PEG.

Detailed Description

This is a prospective, randomized, single-center, single-blinded, non-inferiority trial.

Participants with out patient colonoscopy arranged will be included and randomized in a 1:1 ratio to receive either a split dose of 4L PEG + Electrolyte (Klean-prep® ) or 1L Klean-prep® plus 2 sachets SPMC (Picoprep®).

Trained endoscopists will be using the Boston Bowel Preparation Scale (BBPS) to assess the quality of bowel preparation. Patient would also rate the tolerance, compliance and adverse effect by filling the questionnaire before the colonoscopy.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
158
Inclusion Criteria
  1. Patient who mentally capable to consent for participating the trial
  2. 18 - 65 years old
  3. Scheduled for 1st colonoscopy
  4. Elective outpatient colonoscopy
Exclusion Criteria
  1. Prior colorectal or abdominal-pelvic surgery
  2. Inflammatory bowel disease
  3. Active bowel condition eg intestinal obstruction
  4. Gastrointestinal disorders eg active ulcer, gastric outlet obstruction, gastroparesis and hypomotility syndrome
  5. Recent myocardial infarction, congestive heart failure, uncontrolled hypertension
  6. Renal dysfunction, hepatic disease
  7. Patient on long term tranquilizer, anti-spasmodic, prokinetic, laxative or antidiarrhoeal agents
  8. Hypersensitivity to PEG or SPMC solution
  9. Pregnant or breastfeeding women
  10. Inability to give informed consent

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
4L Klean Prep®4L Klean Prep®Drug: 59g polyethylene glycol, 5.685g Na sulphate, 1.685g Na bicarbonate, 1.465g NaCl, 0.7425g KCl and aspartame 0.0494g
1L Klean prep® and 2 sachets Picoprep®1L Klean prep® and 2 sachets Picoprep®Drug: 59g polyethylene glycol, 5.685g Na sulphate, 1.685g Na bicarbonate, 1.465g NaCl, 0.7425g KCl, aspartame 0.0494g, sodium picosulfate 0.01g, magnesium oxide 3.5g, citric acid 12.0g
Primary Outcome Measures
NameTimeMethod
Boston Bowel Preparation Score (BBPS)Up to 24 weeks

Adequate bowel preparation is defined as a total BPPS score \>/= 6 in which all three segments had score \>/=2

Secondary Outcome Measures
NameTimeMethod
Patient tolerability to bowel preparation using Likert scaleUp to 24 weeks

Patient are requested to fill in questionnaire on the day of colonoscopy. Candidate are asked to rate the frequency of complications between 'none', 'mild', 'moderate' and 'severe'. 'None' being the best outcome and 'severe' being the worst outcome.

Patient compliance towards bowel preparationTill the day of procedure

Proportion of patient able to complete the whole bowel preparation as instructed by protocol

Proportion of patient requiring repeat colonoscopyUp to 24 weeks

Proportion of incomplete colonoscopy due to inadequate bowel preparation Patient will be attended by physicians and blood taking will be arranged

Incidence of treatment related adverse eventsUp to 24 weeks

Patient will be monitored after colonoscopy for any complications

Trial Locations

Locations (1)

Queen Elizabeth Hospital

🇭🇰

Kowloon, Hong Kong

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