S631 Overnight Split Dosing With 1L Polyethylene Glycol + Ascorbic Acid Bowel Preparation Delivers High Levels of High-Quality Cleansing for Colonoscopy: A Sub-Analysis of a Large Real-World Study

Abstract

Introduction: Clinical guidelines recommend evening/morning split dosing for routine colonoscopy procedures. Overnight split dosing with 1 liter polyethylene glycol + ascorbic acid (1L PEG+ASC) has demonstrated strong cleansing performance in clinical trials. Here we report a sub-analysis from the largest real-world study to date of 1L PEG+ASC, evaluating patients who received this split dosing regimen. Methods: An observational, multicenter, retrospective study evaluated the medical records of colonoscopy outpatients between July 2019 and September 2021 at 12 centers in Spain and Portugal. Eligible adults (aged ≥18 years) had a screening, surveillance, or diagnostic colonoscopy after an evening/morning (split dose) or same-day regimen of 1L PEG+ASC. Bowel cleansing was assessed by site endoscopists using the Boston Bowel Preparation Scale (BBPS). Segmental BBPS scores of 3 defined high-quality cleansing. High adherence was defined as consumption of ≥75% of each dose and safety was assessed based on registered adverse events (AEs). BBPS scores were compared between time to colonoscopy groups with the Wilcoxon rank-sum test. Results: A total of 13,169 patients from the 12 centers were enrolled in the study, of which 4,316 received a split-dosing regimen and were included in this analysis. In the split-dose group, 48.0% of patients were male, mean (SD) age was 58.1 ± 13.4 years, and 33.4% were ≥65 years old. An overall BBPS score of 9 was attained in 58.3% of patients (Figure A). High rates of BBPS 3 were observed in all segments (Figure B). There was no effect of time lapse to colonoscopy on segmental cleansing in the transversal and left colon (Figure C). Only 1.6% of colonoscopies were incomplete, 0.39% due to poor preparation. Overall, 3.9% (95% CI: 3.4%–4.6%) of patients experienced an AE. The main AEs were nausea (2.4%), vomiting (1.2%), and abdominal pain (0.4%). Adherence was high at 97.6% of those 1,834 patients who reported volume intake. Conclusion: Results from this analysis show that overnight split dosing with 1L PEG+ASC delivered an excellent overall and segmental bowel cleansing quality in real-world settings.Figure 1.: Bowel cleansing performance of split dose 1L PEG+ASC: (A) Rates of overall colon high-quality cleansing (BBPS score >6); (B) Rates of segmental high-quality cleansing (BBPS score 3); (C) Effect of time to colonoscopy on mean segmental BBPS scores.