36 - One-Liter Polyethylene Glycol + Ascorbic Acid Bowel Preparation Delivers High Levels of Adequate and High-Quality Bowel Cleansing for Colonoscopy: A Real-World, Multicenter, Observational Study of Over 13,000 Patients

Cátia Arieira, MD¹, José Cotter, MD¹, Ricardo Gorjão, MD², Vicente Lorenzo-Zúñiga, MD³, Miguel A. Pantaleón Sánchez, MD⁴, David Carral Martínez, MD⁵, Fernándo Sábado, MD⁶, Elena Pérez Arellano, MD⁷, Blas J. Gómez Rodríguez, MD⁸, Antonio López Cano, MD⁹, Salvador Machlab, MD¹⁰, Jose M. Esteban López-Jamar, MD¹¹, Elena Velasco, MD¹¹, Sarbelio Rodriguez, MD¹², Juha Halonen, PhD¹³, Fatma Akriche, MD¹³, Carmen Turbí Disla, MD^14
1Hospital da Senhora da Oliveira, Guimarães, Braga, Portugal; ²Hospital CUF Descobertas, Lisbon, Lisboa, Portugal; ³Hospital HM Sant Jordi, Barcelona, Catalonia, Spain; ⁴Hospital del Mar, Barcelona, Catalonia, Spain; ⁵Hospital San Rafael, A Coruña, Galicia, Spain; ⁶Consorcio Hospitalario Provincial de Castelló, Valencia, Comunidad Valenciana, Spain; ⁷Hospital La Zarzuela, Madrid, Madrid, Spain; ⁸Hospital Quirón Salud Sagrado Corazón, Sevilla, Andalucia, Spain; ⁹Hospital Doctor López Cano, Cádiz, Andalucia, Spain; ¹⁰Parc Taulı́ Hospital Universitari & Institut d’Investigació i Innovació Parc Taulı́ I3PT, Sabadell, Catalonia, Spain; ¹¹Hospital Universitario Clínico San Carlos, Madrid, Madrid, Spain; ¹²Hospital Ruber Juan Bravo, European University of Madrid, Madrid, Madrid, Spain; ¹³Norgine, Medical Affairs, Harefield, England, United Kingdom; ¹⁴Norgine, Madrid, Madrid, Spain

Introduction: 1L polyethylene glycol + ascorbic acid preparation (1L PEG+ASC) has shown high bowel cleansing efficacy in clinical trials. Here we report the largest real-world study on 1L PEG+ASC effectiveness to date.

Methods: An observational, multicenter, retrospective study evaluated outpatients who underwent a colonoscopy between July 2019 and September 2021 at 12 centers in Spain and Portugal. Adults (aged ≥18 years) who had a screening, surveillance, or diagnostic colonoscopy after 1L PEG+ASC as an evening/morning (split dose) or same-day regimen were included. Bowel cleansing was assessed using the Boston Bowel Preparation Scale (BBPS). Adequate cleansing success was defined as a total BBPS score ≥6 with all segmental scores ≥2. Segmental BBPS scores of 3 defined high-quality cleansing. Safety was assessed through registered adverse events (AEs). Cleansing rates between subgroups were compared with the Chi-square test and BBPS scores with the Wilcoxon rank-sum test.

Results: A total of 13,169 patients were included; 48.6% of patients were male, mean (SD) age was 57.0 ± 13.1 years. The main colonoscopy indication was screening (41.9%), followed by diagnostic (29.4%). Most patients (67.2%) received a same-day dosing regimen. Overall cleansing success was achieved in 89.3% (95% CI: 88.7%–89.8%) of patients. High-quality cleansing of the right colon was attained in 49.3% of patients (95% CI: 48.4%–50.2%). The split-dose regimen attained superior adequate colon cleansing success versus the same-day regimen (94.7% vs. 86.7%; P < 0.0001) and superior high-quality cleansing of the right colon (65.4% vs. 41.4%; P < 0.0001). Rates of adequate bowel cleansing per segment were high for all regimens (Figure 1A). Overall and segmental BBPS scores were significantly greater with the split-dose versus same-day regimen (Figure 1B). Effect of time to colonoscopy on mean overall BBPS score was statistically significant in patients receiving same-day dosing (Figure 1C). Colonoscopy was completed in 97.3% of patients; only 0.8% of procedures were incomplete due to poor preparation. The incidence of AEs was 2.3% (95% CI: 2.0%–2.5%); the main AEs were nausea (1.2%), vomiting (0.8%), and abdominal pain (0.2%).

Discussion: Results from this large study confirm the high cleansing effectiveness and good tolerability of 1L PEG+ASC in real-world settings.



Disclosures:


Cátia Arieira, MD¹, José Cotter, MD¹, Ricardo Gorjão, MD², Vicente Lorenzo-Zúñiga, MD³, Miguel A. Pantaleón Sánchez, MD⁴, David Carral Martínez, MD⁵, Fernándo Sábado, MD⁶, Elena Pérez Arellano, MD⁷, Blas J. Gómez Rodríguez, MD⁸, Antonio López Cano, MD⁹, Salvador Machlab, MD¹⁰, Jose M. Esteban López-Jamar, MD¹¹, Elena Velasco, MD¹¹, Sarbelio Rodriguez, MD¹², Juha Halonen, PhD¹³, Fatma Akriche, MD¹³, Carmen Turbí Disla, MD¹⁴, 36, One-Liter Polyethylene Glycol + Ascorbic Acid Bowel Preparation Delivers High Levels of Adequate and High-Quality Bowel Cleansing for Colonoscopy: A Real-World, Multicenter, Observational Study of Over 13,000 Patients, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.