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Systematic review and meta-analysis of colon cleansing preparations in patients with inflammatory bowel disease

World Journal of Gastroenterology 2017年第32期23卷 5994-6002页

作者： Sophie Restellini Omar Kherad Talat Bessissow Charles Ménard Myriam Martel maryam taheri tanjani Peter L Lakatos Alan N Barkun division of gastroenterology department of medicine mcgill university health center division of internal medicine department of medicine la tour hospital and university of geneva division of gastroenterology department of medicine university of sherbrooke department of family medicine queens universitykingston department of clinical epidemiology mcgill university and the mcgill university health center

AIM To performed a systematic review and meta-analysis to determine any possible differences in terms of effectiveness, safety and tolerability between existing colon-cleansing products in patients with inflammatory bowel *** Systematic searches were performed( January 1980-September 2016) using MEDLINE, EMBASE, Scopus, CENTRAL and ISI Web of knowledge for randomized trials assessing preparations with or without adjuvants, given in split and non-split dosing, and in high(> 3 L) or low-volume(2 L or less) regimens. Bowel cleansing quality was the primary outcome. Secondary outcomes included patient willingness-torepeat the procedure and side effects/*** Out of 439 citations, 4 trials fulfilled our inclusion criteria(n = 449 patients). One trial assessed the impact of adding simethicone to polyethylene glycol(PEG) 4 L with no effect on bowel cleansing quality, but a better tolerance. Another trial compared senna to castor oil, again without any differences in term of bowel cleansing. Two trials compared the efficacy of PEG high-volume vs PEG low-volume associated to an adjuvant in split-dose regimens: PEG low-dose efficacy was not different to PEG high-dose; OR = 0.84(0.37-1.92). A higher proportion of patients were willing to repeat low-volume preparations vs high-volume; OR = 5.11(1.31-20.0). CONCLUSION In inflammatory bowel disease population, PEG lowvolume regimen seems not inferior to PEG high-volume to clean the colon, and yields improved willingness-torepeat. Further additional research is urgently required to compare contemporary products in this population.

关键词： Inflammatory bowel disease Polyethylene glycol Colonoscopy Meta-analysis

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