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Bowel PreparationNCT03965182

Compare Polyethylene Glycol and Sodium Picosulfate Alone or Combined

A study testing PEG, PEG plus SPMC and SPMC in people with Bowel Preparation, run by Dalin Tzu Chi General Hospital.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Sodium picosulfate/magnesium citrate (SPMC) is generally better tolerated than PEG, its cleansing effect remains uncertain. While most studies showed SPMC was non-inferior to PEG, some studies reported that SPMC was less effective than PEG. Read more about this study

Who is it for?
Ages 20 to 80 yearsHealthy volunteers can take part
Conditions the study is for
Bowel Preparation
What is being tested?
PEG, PEG plus SPMC and SPMC
Could I receive a placebo?
No, everyone receives an active treatment
How many people
600 participants
Where
No sites listed yet
Study dates
1 Jun 2019to 31 May 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 to 80 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Eligible patients will include those anticipated to undergo colonoscopy, aged 20 to 80 at the time of enrollment.

Who cannot join

  • previous colon resection, gastrointestinal obstruction, ileus, intestinal perforation, toxic megacolon, active stage of inflammatory bowel disease, congestive heart failure (New York Heart Association Class III or IV),acute cardiovascular disease, uncontrolled arterial hypertension (systolic pressure >170 mmHg, diastolic pressure>100 mmHg), severe liver cirrhosis (Child-Pugh score C) or renal failure (creatinine clearance<30 mL/minute) or any allergy to, PEG, or sodium picosulfate solution, phenylketonuria, and glucose-6-phosphate dehydrogenase deficiency.

Trial locations and contacts

No sites are listed yet.

About this study

Official title: A Head-to-head Comparison Study of Polyethylene Glycol, Polyethylene Glycol Plus Sodium Picosulfate, and Sodium Picosulfate

Sodium picosulfate/magnesium citrate (SPMC) is generally better tolerated than PEG, its cleansing effect remains uncertain. While most studies showed SPMC was non-inferior to PEG, some studies reported that SPMC was less effective than PEG. To improve the bowel cleansing effect of SPMC, splitting the dose by using one sachet the evening before colonoscopy and the other sachet 4 to 5 hours before colonoscopy in the morning, has been proposed.Adding bisacodyl to the regimen also has been shown to be helpful. Some side effects, such as hyponatremia, dehydration and sleep disturbance, were reported to be more commonly associated with SPMC than with PEG.

To enhance the efficacy and reduce the side effects, two studies have evaluated the combination of SPMC and PEG, with conflicting results.The effect of combining PEG and SPMC should be best appreciated with head-to-head comparison with PEG and SPMC alone at the same time.

Read more

Therefore we designed this head-to-head comparison study for 2 L PEG, 1L PEG plus one sachet of SPMC and 2 sachet of SPMC, all with split-dose and the addition of 10 ml bisacodyl. Our hypothesis is the bowel cleansing effect of the combination regimen was not inferior to PEG alone. The tolerability, acceptability and side effects of the 3 regimen will also be evaluated.

Patients will be randomly assigned to either PEG, PEG plus SPMC or SPMC group, in a 1:1:1 ratio using a computer-generated sequence. The treatment allocation will be concealed and revealed by non-research medical personnel at the screening visit.

Being tested
PEG, PEG plus SPMC, SPMC
Keywords
colon preparation, ,, polyethylene glycol, sodium picosulfate/magnesium citrate

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PEGDrug

    2 sachets of PEG will be used as the bowel prep regimen.

  • PEG plus SPMCDrug

    one sachet of PEG and one sachet will be administered as the bowel prep regimen

  • SPMCDrug

    2 sachets will be administered as the bowel prep regimen.

Study groups in NCT03965182
Study groupRoleWhat they receive
PEG groupActive comparatorPatients in the PEG group were instructed to take the first sachet of PEG at 19:00 hours the day before colonoscopy and the second one at 06:00 hours on the morning of the day of colonoscopy.
Receives: Drug: PEG
PEG plus SPMC groupActive comparatorPatients in the PEG plus SPMC group will be instructed to take the SPMC sachet at 19:00 hours the day before colonoscopy and the PEG sachet at 6:00 hours on the morning of the day of colonoscopy.
Receives: Drug: PEG plus SPMC
SPMC groupActive comparatorPatients in the SPMC group were instructed to take the first sachet of SPMC at 19:00 hours the day before colonoscopy and the second one at 06:00 hours on the morning of the day of colonoscopy.
Receives: Drug: SPMC

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Aronchick scale

    a validated assessment that describes the visual appearance of the colon on a four-point scale.

    Measured: through study completion, average 30 minutes

  2. Boston Bowel Preparation Scale

    BBPS is based on the summation of the preparation scores from three segments of the colon (cecum and ascending, transverse colon and left colon). A segment score of 0 describes an"unprepared colon segment with mucosa not well seen due to solid stool that cannot be cleared"; segment score 1: "portion of mucosa of the colon segment seen, but other areas of the colon are not well seen due to staining, residual stool and⁄or opaque liquid"; segment score 2: "minor amount of residual staining, small fragments of stool and⁄or opaque liquid, but mucosa of colon segment seen well"; segment score 3: "entire mucosa of the colon segment seen well with no residual staining, small fragments of stool and⁄or opaque liquid".

    Measured: through study completion, average 30 minutes

Secondary outcomes (1)
  1. Adenoma detection rate

    Measured: when pathology of polyps become available, average in one week.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 May 2019
  2. Study start1 Jun 2019 (estimated)
  3. Primary completion31 May 2020 (estimated)
  4. Study completion31 May 2020 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
600 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03965182
Sponsor's protocol ID
A10801001
Status last verified
Apr 2019
First submitted
23 May 2019
Last updated
28 May 2019
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Froehlich F, Wietlisbach V, Gonvers JJ, Burnand B, Vader JP. Impact of colonic cleansing on quality and diagnostic yield of colonoscopy: the European Panel of Appropriateness of Gastrointestinal Endoscopy European multicenter study. Gastrointest Endosc. 2005 Mar;61(3):378-84. doi: 10.1016/s0016-5107(04)02776-2.

    PubMed 15758907
  • Harewood GC, Sharma VK, de Garmo P. Impact of colonoscopy preparation quality on detection of suspected colonic neoplasia. Gastrointest Endosc. 2003 Jul;58(1):76-9. doi: 10.1067/mge.2003.294.

    PubMed 12838225
  • Rex DK, Imperiale TF, Latinovich DR, Bratcher LL. Impact of bowel preparation on efficiency and cost of colonoscopy. Am J Gastroenterol. 2002 Jul;97(7):1696-700. doi: 10.1111/j.1572-0241.2002.05827.x.

    PubMed 12135020
  • Enestvedt BK, Tofani C, Laine LA, Tierney A, Fennerty MB. 4-Liter split-dose polyethylene glycol is superior to other bowel preparations, based on systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2012 Nov;10(11):1225-31. doi: 10.1016/j.cgh.2012.08.029. Epub 2012 Aug 30.

    PubMed 22940741
  • Marshall JB, Pineda JJ, Barthel JS, King PD. Prospective, randomized trial comparing sodium phosphate solution with polyethylene glycol-electrolyte lavage for colonoscopy preparation. Gastrointest Endosc. 1993 Sep-Oct;39(5):631-4. doi: 10.1016/s0016-5107(93)70213-8.

    PubMed 8224683
  • Valiante F, Bellumat A, De Bona M, De Boni M. Bisacodyl plus split 2-L polyethylene glycol-citrate-simethicone improves quality of bowel preparation before screening colonoscopy. World J Gastroenterol. 2013 Sep 7;19(33):5493-9. doi: 10.3748/wjg.v19.i33.5493.

    PubMed 24023492
  • de Leone A, Tamayo D, Fiori G, Ravizza D, Trovato C, De Roberto G, Fazzini L, Dal Fante M, Crosta C. Same-day 2-L PEG-citrate-simethicone plus bisacodyl vs split 4-L PEG: Bowel cleansing for late-morning colonoscopy. World J Gastrointest Endosc. 2013 Sep 16;5(9):433-9. doi: 10.4253/wjge.v5.i9.433.

    PubMed 24044042
  • Clark RE, Godfrey JD, Choudhary A, Ashraf I, Matteson ML, Bechtold ML. Low-volume polyethylene glycol and bisacodyl for bowel preparation prior to colonoscopy: a meta-analysis. Ann Gastroenterol. 2013;26(4):319-324.

    PubMed 24714413
  • Katz PO, Rex DK, Epstein M, Grandhi NK, Vanner S, Hookey LC, Alderfer V, Joseph RE. A dual-action, low-volume bowel cleanser administered the day before colonoscopy: results from the SEE CLEAR II study. Am J Gastroenterol. 2013 Mar;108(3):401-9. doi: 10.1038/ajg.2012.441. Epub 2013 Jan 15.

    PubMed 23318484
  • Rex DK, Katz PO, Bertiger G, Vanner S, Hookey LC, Alderfer V, Joseph RE. Split-dose administration of a dual-action, low-volume bowel cleanser for colonoscopy: the SEE CLEAR I study. Gastrointest Endosc. 2013 Jul;78(1):132-41. doi: 10.1016/j.gie.2013.02.024. Epub 2013 Apr 6.

    PubMed 23566639
  • Kim HG, Huh KC, Koo HS, Kim SE, Kim JO, Kim TI, Kim HS, Myung SJ, Park DI, Shin JE, Yang DH, Lee SH, Lee JS, Lee CK, Chang DK, Joo YE, Cha JM, Hong SP, Kim HJ. Sodium Picosulfate with Magnesium Citrate (SPMC) Plus Laxative Is a Good Alternative to Conventional Large Volume Polyethylene Glycol in Bowel Preparation: A Multicenter Randomized Single-Blinded Trial. Gut Liver. 2015 Jul;9(4):494-501. doi: 10.5009/gnl14010.

    PubMed 25287163
  • Gweon TG, Kim SW, Noh YS, Hwang S, Kim NY, Lee Y, Lee SW, Lee SW, Lee JY, Lim CH, Hun Kim H, Kim JS, Kyung Cho Y, Myung Park J, Seok Lee I, Myung-Gyu Choi. Prospective, randomized comparison of same-day dose of 2 different bowel cleanser for afternoon colonoscopy: picosulfate, magnesium oxide, and citric acid versus polyethylene glycol. Medicine (Baltimore). 2015 Apr;94(13):e628. doi: 10.1097/MD.0000000000000628.

    PubMed 25837751
  • Manes G, Amato A, Arena M, Pallotta S, Radaelli F, Masci E. Efficacy and acceptability of sodium picosulphate/magnesium citrate vs low-volume polyethylene glycol plus ascorbic acid for colon cleansing: a randomized controlled trial. Colorectal Dis. 2013 Sep;15(9):1145-53. doi: 10.1111/codi.12246.

    PubMed 23581277
  • Dakkak M, Aziz K, Bennett JR. Short report: comparison of two orally administered bowel preparations for colonoscopy--polyethylene glycol and sodium picosulphate. Aliment Pharmacol Ther. 1992 Aug;6(4):513-9. doi: 10.1111/j.1365-2036.1992.tb00566.x.

    PubMed 1420744
  • Jin Z, Lu Y, Zhou Y, Gong B. Systematic review and meta-analysis: sodium picosulfate/magnesium citrate vs. polyethylene glycol for colonoscopy preparation. Eur J Clin Pharmacol. 2016 May;72(5):523-32. doi: 10.1007/s00228-016-2013-5. Epub 2016 Jan 28.

    PubMed 26818765

Questions about this trial

What is this clinical trial studying?

A study testing PEG, PEG plus SPMC and SPMC in people with Bowel Preparation, run by Dalin Tzu Chi General Hospital.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 28 May 2019. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Yu-Hsi Hsieh, MD (886-5-2648000 ext. 5204, hsiehyuhsi1112@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Aronchick scale (time frame: through study completion, average 30 minutes). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03965182, which also lists 23 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 May 2019.

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