Two Doses of Linaclotide Replaced 1 Liter of Polyethylene Glycol-Electrolyte Lavage Solution in Bowel Preparation for Colonoscopy
Douglas K. Rex, MD, MASGE, reviewing Zhang C, et al. Gastrointest Endosc 2022 Dec 23.
In a study from China, 548 patients were randomized to receive 2 L of polyethylene glycol (PEG) on the day of colonoscopy or 290 µg of linaclotide the day before colonoscopy, plus a second dose of linaclotide and 1 L of PEG on the day of colonoscopy. The rate of adequate preparation was 91.6% with 2 L of PEG versus 90.5% with the linaclotide preparation.
Compared with patients who received a single 2-L dose of PEG, patients in the linaclotide arm had less nausea (7.7% vs 17.1%), less vomiting (4.0% vs 10.9%), and greater willingness to repeat the bowel preparation (95.2% vs 82.2%).
COMMENTThese ultra-low doses are unlikely to reach adequate levels of effectiveness in a U.S. population. However, the authors suggest that linaclotide could be a useful way to decrease liquid preparation doses for low-risk patients or patients who tolerate liquid active ingredients poorly.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Zhang C, Chen X, Tang B, et al. A novel ultra-low volume regimen combining 1 L polyethylene glycol and linaclotide versus 2 L polyethylene glycol for colonoscopy cleansing in low-risk individuals: a randomized controlled trial. Gastrointest Endosc 2022 Dec 23. (Epub ahead of print) (https://doi.org/10.1016/j.gie.2022.12.015)
