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Application of Linaclotide Capsule in Bowel Preparation for Patients at High Risk of Inadequate Bowel Preparation

Not Applicable
Completed
Conditions
Colonoscopy
Interventions
Drug: 3 L PEG + placebo
Registration Number
NCT05379491
Lead Sponsor
Zhiguo Liu
Brief Summary

The purpose of this study is to compare the colon cleansing quality of linaclotide versus control in adult patients at high risk of inadequate bowel preparation: one group will receive polyethylene glycol solution (PEG) split dose (1 L + 2 L) plus linaclotide and the other group PEG (1 L + 2 L) plus placebo before colonoscopy.

Detailed Description

The objective of this trial is to compare the colon cleanliness achieved with PEG split dose (1 L + 2 L) + linaclotide versus PEG split dose (1 L + 2 L) + placebo for patients scheduled for a colonoscopy at high risk of inadequate bowel preparation. The target patients are those with constipation, poor bowel preparation history, history of abdominal/pelvic surgery, comorbidity (diabetes, Parkinson's disease, stroke, or history of spinal cord injury), BMI \> 25 kg/m2, age \> 70, tricyclic antidepressants usage, or opioid usage, as defined by the latest version of Bowel Preparation Guidelines.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
720
Inclusion Criteria
  • scheduled for colonoscopy
  • age ≥ 18
  • meet any of the followings: functional constipation according to Rome IV criteria, poor bowel preparation history, BMI > 25 kg/m2, age > 70, history of abdominal/pelvic surgery, comorbidity (diabetes, Parkinson's disease, stroke, or history of spinal cord injury), antidepressant usage, opioid usage
  • willing to provide informed consent
Exclusion Criteria
  • unable to cooperate with questionnaires
  • uncontrolled hypertension (systolic .170 mm Hg and diastolic.100mmHg)
  • pregnancy or lactation
  • toxic colitis, or megacolon
  • allergy to preparation components
  • active inflammatory bowel disease
  • clinically significant electrolyte abnormalities
  • a history of severe renal, liver, or cardiac insufficiency
  • has already been enrolled in the study
  • gastrointestinal obstruction
  • obvious gastroparesis or gastric retention
  • bowel perforation
  • polyp syndrome
  • history of colectomy
  • any other condition that is inappropriate for enrollment as judged by the investigator.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
3 L PEG + Placebo3 L PEG + placeboBowel preparation for colonoscopy was performed with 3 L polyethylene glycol solution combined with 2-day placebo.
3 L PEG + Linaclotide3 L PEG + linaclotideBowel preparation for colonoscopy was performed with 3 L polyethylene glycol solution combined with 2-day linaclotide.
Primary Outcome Measures
NameTimeMethod
Bowel preparation adequate rate48 hours

The rate of participants with all colon segment scores (proximal colon, transverse colon, distal colon) are ≥ 2 according to Boston Bowel Preparation Scale.

Number of adenomas per patient48 hours

If there is no significant difference in the first primary outcome between the two groups, compare the average number of adenomas per patient detected by colonoscopy.

Secondary Outcome Measures
NameTimeMethod
Tolerance to bowel preparation1 Day of colonoscopy

It will be subjective and assessed as non, mild, moderate, severe.

Tolerance to colonoscopy1 Day of colonoscopy

It will be subjective and assessed as non, mild, moderate, severe.

Subject willingness to repeat the preparation1 Day of colonoscopy

Survey

Average number of polyps per patient1 Day of colonoscopy

Average number of polyps detected per patient by colonoscopy in each arm

Average number of adenomas per patient1 Day of colonoscopy

Average number of adenomas detected per patient by colonoscopy in each arm

Withdrawal time1Day of colonoscopy

the time from cecal identification to the withdrawal of the colonoscopy across the anus minus the time of polypectomy.

Cecal intubation rate for colonoscopies1 Day of colonoscopy

Cecal intubation was defined as reaching the ileocecal valve

Trial Locations

Locations (8)

Ningxia Hui Autonomous Region People's Hospital

🇨🇳

Yinchuan, Ningxia, China

Xi'an Jiaotong University Second Affiliated Hospital

🇨🇳

Xi'an, Shaanxi, China

Shaanxi Provincial People's Hospital

🇨🇳

Xi'an, Shaanxi, China

Linfen Central Hospital

🇨🇳

Linfen, Shanxi, China

The Second Hospital of Shanxi Medical University

🇨🇳

Taiyuan, Shanxi, China

Xijing Hospital of Digestive Diseases

🇨🇳

Xi'an, Shaanxi, China

Xi'an Central Hospital

🇨🇳

Xi'an, Shaanxi, China

Air Force 986 Hospital

🇨🇳

Xi'an, Shaanxi, China

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