Efficacy of mosapride citrate with polyethylene glycol solution for colonoscopy preparation.
OBJECTIVE
To evaluate the efficacy and safety of adjunctive mosapride citrate for bowel preparation before colonoscopy.


METHODS
We conducted a randomized, double-blind, placebo-controlled study with mosapride in addition to polyethylene glycol (PEG)-electrolyte solution. Of 250 patients undergoing colonoscopy, 124 were randomized to receive 2 L PEG plus 15 mg of mosapride citrate (mosapride group), and 126 received 2 L PEG plus placebo (placebo group). Patients completed a questionnaire reporting the acceptability and tolerability of the bowel preparation process. The efficacy of bowel preparation was assessed by colonoscopists using a 5-point scale based on Aronchick's criteria. The primary end point was optimal bowel preparation rates (scores of excellent/good/fair vs poor/inadequate).


RESULTS
A total of 249 patients were included in the analysis. In the mosapride group, optimal bowel preparation rates were significantly higher in the left colon compared with the placebo group (78.2% vs 65.6%, P < 0.05), but not in the right colon (76.5% vs 66.4%, P = 0.08). After excluding patients with severe constipation, there was a significant difference in bowel preparation in both the left and right colon (82.4% vs 66.7%, 80.8% vs 67.5%, P < 0.05, P < 0.01). The incidence of adverse events was similar in both groups. Among the subgroup who had previous colonoscopy experience, a significantly higher number of patients in the mosapride group felt that the current preparation was easier compared with patients in the placebo group (34/72 patients vs 24/74 patients, P < 0.05).


CONCLUSIONS
Mosapride citrate may be an effective and safe adjunct to PEG-electrolyte solution that leads to improved quality of bowel preparation, especially in patients without severe constipation.
Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan. mtajika@aichi-cc.jp
Masahiro
M
Tajika
Yasumasa
Y
Niwa
Vikram
V
Bhatia
Hiroki
H
Kawai
Shinya
S
Kondo
Akira
A
Sawaki
Nobumasa
N
Mizuno
Kazuo
K
Hara
Susumu
S
Hijioka
Kazuya
K
Matsumoto
Yuji
Y
Kobayashi
Akira
A
Saeki
Asana
A
Akabane
Koji
K
Komori
Kenji
K
Yamao
D000368:Aged; D001549:Benzamides / Q000008:administration & dosage* / Q000009:adverse effects; D002400:Cathartics / Q000008:administration & dosage* / Q000009:adverse effects; D003113:Colonoscopy / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage* / Q000009:adverse effects; D010349:Patient Compliance; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage* / Q000009:adverse effects; D011795:Surveys and Questionnaires
D001549:Benzamides; D002400:Cathartics; D009025:Morpholines; D017366:Serotonin Receptor Agonists; D011092:Polyethylene Glycols; C062720:mosapride