P158 Comparison of 4L polyethylene glycol and 2L polyethylene glycol plus ascorbic acid in patients with inactive ulcerative colitis; randomised, single blind, multicentre study
E. S. Kim*1, B. I. Jang2, K. O. Kim2, E. Y. Kim3, S. W. Jeon4, H. S. Lee4, J. Heo4, Y. J. Lee1, H. J. Kim5
1Keimyung University School of Medicine, Internal Medicine, Daegu, South Korea, 2Yeungnam University College of Medicine, Internal Medicine, Daegu, South Korea, 3Catholic University of Daegu, Department of Internal Medicine, Daegu, South Korea, 4Kyungpook National University School of Medicine, Department of Internal Medicine, Daegu, South Korea, 5Gyeongsang National University School of Medicine, Internal Medicine, Jinju, South Korea
Although colonoscopy preparation may cause symptom flares in patients with ulcerative colitis (UC), little has been known about the standard preparation regimen in this population. This study aimed to compare 4L polyethylene glycol (4L-PEG) with 2L polyethylene glycol plus ascorbic acid (2L-PEG-Asc) in patients with quiescent UC in terms of tolerance, efficacy, and safety of the agents.
Patients with inactive UC scheduled to undergo colonoscopy for surveillance or check of mucosal healing purposes were prospectively enrolled in 5 tertiary hospitals. They were randomly allocated into 4L-PEG and 2L-PEG-Asc. Boston Bowel Preparation Scale (BBPS) was used for the preparation quality. Symptoms were assessed using the Simple Clinical Colitis Activity Index (SCCAI) before colonoscopy and at 1 week and 4 weeks after the procedure. After colonoscopy, subjects were asked of their willingness to repeat preparation with the same agent for the next time.
Overall, 108 patients were included in the study (4L-PEG 53, 2L-PEG-Asc 55, median age of diagnosis 42 years, male 76). There was no difference between 2 groups regarding demographic and clinical data, such as age of diagnosis, sex, marital status, education, disease extension, and medication before colonoscopy. Quality of preparation was comparable between groups (BBPS ≥ 6, 96.2% vs 92.7%, p = 0.427). Although 26 patients (24.1%) had increased SCCAI score within 4 weeks after colonoscopy causing medication dose-up or add-on in 8 (7.4%), score rise did not differ between groups. No serious adverse events during preparation were observed in either group. However, the 4L-PEG group was more likely to refuse to repeat preparation with the same agent than 2L-PEG-Asc group (35.8% vs 18.2%, p = 0.038).
PEG-based regimens with different volume are equally effective and safe in inactive UC patients. Low-volume PEG with ascorbic acid is more acceptable to this population.