BACKGROUND: Problems of compliance, quality, and safety of colon preparation regimens have prompted continued investigation with alternative forms of cleansing. OBJECTIVE: To evaluate the efficacy of tegaserod as an adjunct to a polyethylene glycol electrolyte solution (PEG-E), given as a whole dose or split dose, in colonoscopy preparation. DESIGN: Randomized, placebo-controlled, double-blind trial. SETTING: A single university-based hospital. PATIENTS: Patients who were undergoing elective colonoscopy. INTERVENTIONS: A 4-arm randomization scheme that compared tegaserod with a placebo, each with whole-dose or split-dose PEG-E preparation. MAIN OUTCOME MEASUREMENTS: Efficacy of colon cleansing was the primary outcome. Secondary outcomes included adherence, tolerability, adverse effects, and patient perceptions of their preparation quality. RESULTS: A total of 382 patients completed the trial. Patients who received the split-dose preparation had significantly better colon cleansing than those who received the whole-dose preparation (88.9% vs 42.6%, P < .001). The addition of tegaserod did not significantly improve the overall colonoscopy preparation quality compared with a placebo. However, there were fewer poor preparations in the whole-dose PEG-E group (12.4% vs 1.1%, P = .002, Bonferroni correction removes significance) and more excellent preparations in the split-dose group (53.3% vs 38.3%, P = .035, Bonferroni correction removes significance) in favor of tegaserod. Interobserver and intraobserver variability analysis showed substantial agreement among endoscopists. Adherence was significantly lower in the whole-dose group versus the split-dose PEG-E group (68.8% vs 91%, P < .001), independent of the use of tegaserod. Adverse effects were not different between study groups. LIMITATIONS: A 4-arm randomization and the single-center nature of the study. CONCLUSIONS:Tegaserod has a marginal effect on the quality of colonoscopy preparation when used as an adjuvant to PEG-E. The split-dose PEG-E was superior to the whole-dose PEG-E and resulted in better colon cleansing, adherence, and tolerance.
RCT Entities:
BACKGROUND: Problems of compliance, quality, and safety of colon preparation regimens have prompted continued investigation with alternative forms of cleansing. OBJECTIVE: To evaluate the efficacy of tegaserod as an adjunct to a polyethylene glycol electrolyte solution (PEG-E), given as a whole dose or split dose, in colonoscopy preparation. DESIGN: Randomized, placebo-controlled, double-blind trial. SETTING: A single university-based hospital. PATIENTS: Patients who were undergoing elective colonoscopy. INTERVENTIONS: A 4-arm randomization scheme that compared tegaserod with a placebo, each with whole-dose or split-dose PEG-E preparation. MAIN OUTCOME MEASUREMENTS: Efficacy of colon cleansing was the primary outcome. Secondary outcomes included adherence, tolerability, adverse effects, and patient perceptions of their preparation quality. RESULTS: A total of 382 patients completed the trial. Patients who received the split-dose preparation had significantly better colon cleansing than those who received the whole-dose preparation (88.9% vs 42.6%, P < .001). The addition of tegaserod did not significantly improve the overall colonoscopy preparation quality compared with a placebo. However, there were fewer poor preparations in the whole-dose PEG-E group (12.4% vs 1.1%, P = .002, Bonferroni correction removes significance) and more excellent preparations in the split-dose group (53.3% vs 38.3%, P = .035, Bonferroni correction removes significance) in favor of tegaserod. Interobserver and intraobserver variability analysis showed substantial agreement among endoscopists. Adherence was significantly lower in the whole-dose group versus the split-dose PEG-E group (68.8% vs 91%, P < .001), independent of the use of tegaserod. Adverse effects were not different between study groups. LIMITATIONS: A 4-arm randomization and the single-center nature of the study. CONCLUSIONS:Tegaserod has a marginal effect on the quality of colonoscopy preparation when used as an adjuvant to PEG-E. The split-dose PEG-E was superior to the whole-dose PEG-E and resulted in better colon cleansing, adherence, and tolerance.
Authors: Ala I Sharara; Ali H Harb; Fayez S Sarkis; Jean M Chalhoub; Rami Badreddine; Fadi H Mourad; Mahmoud Othman; Omar Masri Journal: World J Gastroenterol Date: 2015-02-14 Impact factor: 5.742
Authors: Grace Clarke Hillyer; Benjamin Lebwohl; Corey H Basch; Charles E Basch; Fay Kastrinos; Beverly J Insel; Alfred I Neugut Journal: Therap Adv Gastroenterol Date: 2013-01 Impact factor: 4.409
Authors: Lisandro Pereyra; Rafael Zamora; Estanislao Jesús Gómez; Carolina Fischer; Guillermo Nicolas Panigadi; Raquel González; Maximiliano Bun; José Manuel Mella; Mariana Omodeo; Pablo Luna; Marcelo Amante; Gabriel Casas; Silvia Pedreira; Daniel Cimmino; Luis Boerr Journal: Am J Gastroenterol Date: 2016-04-12 Impact factor: 10.864