Sodium Picosulfate with Magnesium Citrate (SPMC) Plus Laxative Is a Good Alternative to Conventional Large Volume Polyethylene Glycol in Bowel Preparation: A Multicenter Randomized Single-Blinded Trial

Gut Liver. 2015 Jul;9(4):494-501. doi: 10.5009/gnl14010.

Abstract

Background/aims: We investigated whether sodium picosulfate with magnesium citrate (SPMC) plus bisacodyl compares favorably with conventional polyethylene glycol (PEG) with respect to bowel cleansing adequacy, compliance, and safety.

Methods: We performed a multicenter, prospective, single-blinded study in outpatients undergoing daytime colonoscopies. Patients were randomized into a split preparation SPMC/bisacodyl group and a conventional split PEG group. We compared preparation adequacy using the Boston bowel preparation scale (BBPS), ease of use using a modified Likert scale (LS), compliance/satisfaction level using a visual analogue scale (VAS), and safety by monitoring adverse events during the colonoscopy between the two groups.

Results: A total of 365 patients were evaluated by intention to treat (ITT) analysis, and 319 were evaluated by per protocol (PP) population analysis (153 for SPMC/bisacodyl, 166 for PEG). The mean total BBPS score was not different between the two groups in both the ITT and PP analyses (p>0.05). The mean VAS score for satisfaction and LS score for the ease of use were higher in the SPMC/bisacodyl group (p<0.001). The adverse event rate was lower in the SPMC/bisacodyl group than in the PEG group (p<0.05).

Conclusions: The SPMC/bisacodyl treatment was comparable to conventional PEG with respect to bowel preparation adequacy and superior with respect to compliance, satisfaction, and safety.

Keywords: Bowel preparation; Colonoscopy; Polyethylene glycols; Sodium picosulfate with magnesium citrate.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cathartics / administration & dosage*
  • Citrates / administration & dosage*
  • Citric Acid / administration & dosage*
  • Colon / drug effects*
  • Colon / surgery
  • Colonoscopy*
  • Drug Combinations
  • Drug Therapy, Combination / methods
  • Female
  • Humans
  • Intention to Treat Analysis
  • Laxatives / administration & dosage*
  • Male
  • Middle Aged
  • Organometallic Compounds / administration & dosage*
  • Patient Compliance
  • Patient Satisfaction
  • Picolines / administration & dosage*
  • Polyethylene Glycols / administration & dosage*
  • Preoperative Care / methods
  • Preoperative Care / psychology
  • Single-Blind Method
  • Young Adult

Substances

  • Cathartics
  • Citrates
  • Drug Combinations
  • Laxatives
  • Organometallic Compounds
  • Picolines
  • Citric Acid
  • Polyethylene Glycols
  • picosulfate sodium
  • magnesium citrate