title: Can mosapride citrate reduce the volume of lavage solution for colonoscopy preparation?
abstract: OBJECTIVE
  To evaluate the possibility of reducing the volume of polyethylene glycol (PEG)-electrolyte solution using adjunctive mosapride citrate for colonoscopy preparation.
  
  
  METHODS
  This was a single-center, prospective, randomized, investigator-blinded, non-inferiority study involving 252 patients of both sexes, aged from 20 to 80 years, scheduled for screening or diagnostic colonoscopy in our department. A total of 126 patients was randomized to receive 1.5 L PEG-electrolyte solution plus 15 mg of mosapride (1.5 L group), and 126 received 2 L PEG-electrolyte solution plus 15 mg of mosapride (2 L group). Patients completed a questionnaire on the acceptability and tolerability of the bowel preparation process. The efficacy of bowel preparation was assessed using a 5-point scale based on the Aronchick scale. The primary end point was adequate bowel preparation rates (score of excellent/good/fair) vs (poor/inadequate). Acceptability and tolerability, as well as disease detection, were secondary end points.
  
  
  RESULTS
  A total of 244 patients was included in the analysis. There were no significant differences between the 2 L and 1.5 L groups in age, sex, body mass index, number of previous colonoscopies, and the preparation method used previously. The adequate bowel preparation rates were 88.5% in the 2 L group and 82.8% in the 1.5 L group [95% lower confidence limit (LCL) for the difference = -14.5%, non-inferiority P = 0.019] in the right colon. In the left colon, the adequate bowel preparation rates were 89.3% in the 2 L group and 81.1% in the 1.5 L group (95% LCL = -17.0%, non-inferiority P = 0.066). Compliance, defined as complete (100%) intake of the PEG solution, was significantly higher in the 1.5 L group than in the 2 L group (96.8% vs 85.7%, P = 0.002). The proportion of abdominal distension (none/mild/moderate/severe) was significantly lower in the 1.5 L group than in the 2 L group (36/65/22/3 vs 58/48/18/2, P = 0.040). Within the subgroup who had undergone colonoscopy previously, a significantly higher number of patients in the 1.5 L group than in the 2 L group felt that the current preparation was easier than the previous one (54.1% vs 28.0%, P = 0.001). The disease detection rate was not significantly different between the two groups.
  
  
  CONCLUSIONS
  Although the 1.5 L group had better acceptability and tolerability, 15 mg of mosapride may be insufficient to compensate for a 0.5-L reduction of PEG solution.
authors: Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan. mtajika@aichi-cc.jp
authors: Masahiro
authors: M
authors: Tajika
authors: Yasumasa
authors: Y
authors: Niwa
authors: Vikram
authors: V
authors: Bhatia
authors: Shinya
authors: S
authors: Kondo
authors: Tsutomu
authors: T
authors: Tanaka
authors: Nobumasa
authors: N
authors: Mizuno
authors: Kazuo
authors: K
authors: Hara
authors: Susumu
authors: S
authors: Hijioka
authors: Hiroshi
authors: H
authors: Imaoka
authors: Koji
authors: K
authors: Komori
authors: Kenji
authors: K
authors: Yamao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001549:Benzamides / Q000009:adverse effects / Q000627:therapeutic use*; D002400:Cathartics / Q000009:adverse effects / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D003113:Colonoscopy / Q000009:adverse effects; D004573:Electrolytes / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000009:adverse effects / Q000627:therapeutic use*; D017060:Patient Satisfaction; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D007507:Therapeutic Irrigation / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult
chemical_list: D001549:Benzamides; D002400:Cathartics; D004573:Electrolytes; D009025:Morpholines; D011092:Polyethylene Glycols; C062720:mosapride
keywords: Bowel preparation; Colonoscopy; Mosapride citrate; Polyethylene glycol-electrolyte solution; Prokinetics