Linaclotide in combination with compound polyethylene glycol powder enhances bowel preparation for colonoscopy in patients aged over 60 years: a multi-center, endoscopist-blind, randomized controlled trial.

OBJECTIVES

This study aimed to investigate the efficacy and safety of bowel preparation by linaclotide (Lina) combined with compound polyethylene glycol (PEG) in patients aged over 60 years.

METHODS

A multi-center, endoscopist-blind, randomized controlled trial involved 527 patients aged over 60 years scheduled for colonoscopy at two hospitals in Chongqing from January 2022 to December 2023. Participants were randomly assigned to one of three groups: Lina + 2 litres of PEG (L-PEG), 3 L-PEG, or 2 L-PEG. The primary endpoint was the Boston Bowel Preparation Scale (BBPS), with secondary outcomes including the adequate bowel preparation rate (ABPR), adenoma/polyp detection rate (ADR), cecal intubation rate (CIR), cecal intubation time (CIT), willingness to repeat the colonoscopy, bowel preparation costs, and adverse reactions.

RESULTS

The total BBPS scores, ABPR and CIT in the Lina + 2 L-PEG group and the 3 L-PEG group were superior to those in the 2 L-PEG group(p < 0.05). Compared with the 3 L-PEG group, the Lina + 2 L-PEG group and the 2 L-PEG group demonstrated a higher willingness to repeat the colonoscopy, lower costs, and a lower percentage of mild adverse events(p < 0.05). No statistically significant differences were observed among the groups in terms of ADR and CIR.

CONCLUSIONS

The bowel preparation efficacy of Lina + 2 L-PEG is comparable to that of 3 L-PEG, yet superior to that of 2 L-PEG. Moreover, Lina + 2 L-PEG is associated with fewer adverse reactions, a lower cost, and a higher willingness to repeat the colonoscopy among patients aged over 60 years.