Oral sulfate solution on par with 2L-PEG/Asc for bowel cleansing before colonoscopy

An oral sulfate solution (OSS) demonstrates similar effectiveness to 2 L of polyethylene glycol/ascorbic acid (2L-PEG/Asc) for successful bowel cleansing before colonoscopy and maintains an acceptable tolerability, a recent study has shown.

This prospective, single-centre, single-blinded, noninferiority, randomized controlled trial sought to compare the efficacy and tolerability of an OSS with 2L-PEG/Asc for bowel cleansing prior to colonoscopy. In total, 187 participants were randomly assigned to receive either OSS (n=93) or 2L-PEG/Asc (n=94).

The rate of successful bowel cleansing, evaluated using the Boston Bowel Preparation Scale (BBPS), was the primary outcome. Secondary outcomes included polyp and adenoma detection rates (PDR and ADR), examination time, tolerability and safety. A questionnaire was used to assess palatability, satisfaction, ease of use and intention to reuse.

Eighty of 93 participants (86.0 percent) in the OSS group achieved successful bowel cleansing, showing noninferiority to the 2L-PEG/Asc group (83/94; 88.3 percent), with a difference of –2.3 percent by intention-to-treat analysis (95 percent confidence interval, –12.0 to 7.4). The OSS group had significantly shorter withdrawal time compared with that of the 2L-PEG/Asc group (11.8±5.2 vs 14.3±8.5 minutes; p=0.016).

Palatability, satisfaction, ease of use and intention to reuse were comparable between the OSS and the 2L-PEG/Asc groups. Adverse events were also similar between the two groups. In addition, mucosal erythema (4.3 percent) and aphthous lesions (2.1 percent) were reported only in the 2L-PEG/Asc group.

“OSS is a promising and safe low-volume preparation alternative for colonoscopy,” the authors said.