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Endoscopy
Table 1: Literature-based Analysis of the Efficacy of Sodium Picosulphate/Magnesium Citrate in Bowel Cleansing
Indication Study Publication Year Number of Patients Number (%) of Patients with at Least
on SPMC Adequate Bowel Cleansing
By Study Total
Colonoscopy Brown and Jewell
16
1981 25 23 (92) 91/111 (82)
Roe et al.
7
1984 25 22 (88)
Dakkak et al.
1
1992 29 14 (48)
Pinfield and Stringer
6, a
1999 32 32 (100)
Barium enema Hughes et al.
9
1983 47 40 (85) 398/480 (83)
Singh et al.
13
1985 15 12 (80)
Swarbrick et al.
8
1994 102 97 (95)
b
Kember et al.
17
1995 137 101 (74)
Hawkins et al.
5
1996 45 38 (84)
c
51 39 (76)
c,d
McLeod et al.
10
1998 83 71 (86)
e
Bowel surgery Takada et al.
18
1990 17 11 (65) 157/201 (78)
Tsang et al.
11
1992 25 22 (88)
Burke et al.
19
1994 82 70 (85)
Yoshioka et al.
12
2000 77 54 (70)
All indications 646/792 (82)
SPMC = sodium picosulphate/magnesium citrate. a. Paediatric patients; b. SPMC was administered following a three-day low-residue diet; c. Number of patients estimated from percentages;
d. SPMC was administered following a four-day low-residue diet; e. Number of patients is the mean value of assessments by three observers.
Table 2: Efficacy of Sodium Picosulphate/Magnesium Citrate Compared with Other Bowel-cleansing Agents
Study Comparator SPMC p-value
Active Total Dose (Route) N N (%) Pts with at Least N N (%) Pts with at Least
Adequate Cleansing Adequate Cleansing
Colonoscopy
Dakkak et al.
1
Polyethylene glycol/ 236g/7g/23g/6g/3g (oral) 30 25 (83) 29 14 (48) 0.002
sodium bicarbonate/
sodium sulphate/
sodium chloride/
potassium chloride
a
Pinfield and Stringer
6,b
Bisacodyl plus sodium 10mg (oral) plus 64ml (rectal) 31 22 (71) 32 32 (100) <0.01
phosphate enema for children 1–5 years of age
20mg (oral) plus 128ml (rectal)
for children >5 years of age
Roe et al.
7
(Fluid diet, enema and Not applicable (rectal) 21 10 (48) 25 22 (88) <0.01
rectal washout)
Barium Enema
Hawkins et al.
5
Polyethylene glycol/ 236g/6.8g/22.8g/6.0g/ 47 25 (54)
d
45 38 (84)
d
Not
sodium bicarbonate/ 2.8g (oral) 51 39 (76)
d,e
done
sodium sulphate/
sodium chloride/
potassium chloride
c
Hughes et al.
9
Sennosides A and B
f
One bottle of X-Prep (oral) 55 48 (87) 47 40 (85) NS
(High colonic lavage 1g (rectal)
with Veripaque)
MacLeod et al.
10
Disodium phosphate 21.6g/48.8g (oral) 111 88 (79)
h
83 71 (86)
h
NS
dodecahydrate/sodium
dihydrogen phosphate
dihydrate
g
Swarbrick et al.
8,i
Magnesium citrate 17.7g (oral) 104 84 (81) 102 97 (95) <0.001
Bowel Surgery
Tsang et al.
11
Sodium sulphate 120g (oral) 25 23 (92) 25 22 (88) NS
CP100 electrolyte solution Four sachets (oral) 25 20 (80)
Yoshioka et al.
12
Sodium phosphate Two bottles (oral) 76 61 (80) 77 54 (70) NS
®
N = number; NS = not significant; pts = patients; SPMC = sodium picosulphate/magnesium citrate; a. GoLytely ; b. Study conducted in paediatric subjects 18 months to 16 years of age;
® ® ®
c. Kleen-Prep ; d. Number of patients estimated from percentages; e. SPMC was administered following a four-day low-residue diet; f. X-prep ; g. Fleet Phosphosoda ; h. Number of patients
is the mean value of assessments by three observers; i. SPMC was administered following a three-day low-residue diet.
Results from randomised, observer- or double-blind clinical studies included in the review.
Unless otherwise stated, bowel-cleansing preparations were administered according to manufacturer’s instructions or standard practice.
12 EUROPEAN GASTROENTEROLOGY & HEPATOLOGY REVIEW
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