Meta-analysis: randomized controlled trials of 4-L polyethylene glycol and sodium phosphate solution as bowel preparation for colonoscopy.
BACKGROUND
Randomized controlled trials (RCTs) comparing polyethylene glycol (PEG) with sodium phosphate (NaP) are inconsistent.


OBJECTIVE
To compare the efficacy of and tolerance to PEG vs. NaP for bowel preparation.


METHODS
We used MEDLINE and EMBASE to identify English-language RCTs published between 1990 and 2008 comparing 4-L PEG with two 45 mL doses of NaP in adults undergoing elective colonoscopy. We calculated the pooled odds ratios (ORs) for preparation quality and proportion of subjects completing the preparation.


RESULTS
From 18 trials (n = 2792), subjects receiving NaP were more likely to have an excellent or good quality preparation than those receiving PEG (82% vs. 77%; OR = 1.43; 95% CI, 1.01-2.00). Among a subgroup of 10 trials in which prep quality was reported in greater detail, there were no differences in the proportions of excellent, good, fair or poor preparation quality. Among nine trials that assessed preparation completion rates, patients receiving NaP were more likely to complete the preparation than patients receiving 4-L PEG (3.9% vs. 9.8% respectively did not complete the preparation; OR = 0.40; CI, 0.17-0.88).


CONCLUSIONS
Among 18 head-to-head RCTs of NaP vs. 4-L PEG, NaP was more likely to be completed and to result in an excellent or good quality preparation.
Juluri
R
R
Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Regenstrief Health Center, Indianapolis, IN 46202-2859, USA. rjuluri@iupui.edu
Eckert
G
G
Imperiale
T F
TF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002400:Cathartics / Q000008:administration & dosage*; D003113:Colonoscopy / Q000379:methods*; D004337:Drug Carriers / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000008:administration & dosage*; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011300:Preoperative Care / Q000379:methods; D016032:Randomized Controlled Trials as Topic
D002400:Cathartics; D004337:Drug Carriers; D010710:Phosphates; D011092:Polyethylene Glycols; C018279:sodium phosphate
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