Assessment of Lubiprostone as an Adjunct Therapy for Bowel Preparation in Colonoscopy: A Meta‐Analysis of Randomized Controlled Trials

ABSTRACT Introduction The quality of bowel preparation has a significant impact on the success of colonoscopy. Currently, osmotically balanced polyethylene glycol electrolyte (PEG‐E) solutions are most commonly used for bowel preparation. Recently, lubiprostone (LBP) has been considered a potentiall...

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Main Authors: Fariha Hasan, Muhammad Shahzil, Ayesha Liaquat, Fatima Farooqi, Avneet Singh, Alexander Garcia, Muhammad Yafaa Naveed Chaudhary, Dushyant Singh Dahiya, Tanay‐Veer Gandhi, Andrew Alabd, Rachel Frank
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:JGH Open
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Online Access:https://doi.org/10.1002/jgh3.70186
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author Fariha Hasan
Muhammad Shahzil
Ayesha Liaquat
Fatima Farooqi
Avneet Singh
Alexander Garcia
Muhammad Yafaa Naveed Chaudhary
Dushyant Singh Dahiya
Tanay‐Veer Gandhi
Andrew Alabd
Rachel Frank
author_facet Fariha Hasan
Muhammad Shahzil
Ayesha Liaquat
Fatima Farooqi
Avneet Singh
Alexander Garcia
Muhammad Yafaa Naveed Chaudhary
Dushyant Singh Dahiya
Tanay‐Veer Gandhi
Andrew Alabd
Rachel Frank
author_sort Fariha Hasan
collection DOAJ
description ABSTRACT Introduction The quality of bowel preparation has a significant impact on the success of colonoscopy. Currently, osmotically balanced polyethylene glycol electrolyte (PEG‐E) solutions are most commonly used for bowel preparation. Recently, lubiprostone (LBP) has been considered a potentially effective adjunct to PEG. We conducted a meta‐analysis of randomized controlled trials (RCTs) to evaluate the safety and efficacy of LBP in bowel preparation for colonoscopy. Methods Following PRISMA guidelines, we systematically screened PubMed, Embase, Web of Science, and Cochrane Library for RCTs on LBP as an adjunct to PEG‐E for improving bowel preparation quality for colonoscopy. Statistical analysis was performed on RevMan, using a random‐effects model with the generic inverse variance method to address clinical heterogeneity; results were significant at p < 0.05. Outcomes were reported as relative risks and standard errors. Results This meta‐analysis included seven RCTs with 1206 patients. Adding LBP did not increase the likelihood of an excellent bowel preparation [RR = 1.28, 95% CI: 0.94–1.74, p = 0.12] or contribute to poor preparation [RR = 0.61, 95% CI: 0.36–1.04; p = 0.07]. It also did not affect procedure time [MD = −0.74, 95% CI: −2.91–1.43; p = 0.50], polyp detection rate [RR = 1.07, 95% CI: 0.90–1.26; p = 0.45], or adenoma detection rate [RR = 1.09, 95% CI: 0.75–1.57; p = 0.66]. Conclusion Our meta‐analysis found that LBP, explored as an adjunct to PEG‐E solutions for bowel preparation, offers no significant additive effect on preparation quality before colonoscopy.
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spelling doaj-art-87bec816d2af426da479fad74f8348782025-08-20T02:30:03ZengWileyJGH Open2397-90702025-05-0195n/an/a10.1002/jgh3.70186Assessment of Lubiprostone as an Adjunct Therapy for Bowel Preparation in Colonoscopy: A Meta‐Analysis of Randomized Controlled TrialsFariha Hasan0Muhammad Shahzil1Ayesha Liaquat2Fatima Farooqi3Avneet Singh4Alexander Garcia5Muhammad Yafaa Naveed Chaudhary6Dushyant Singh Dahiya7Tanay‐Veer Gandhi8Andrew Alabd9Rachel Frank10Department of Internal Medicine Cooper University Hospital Camden New Jersey USAPenn State Health Milton S. Hershey Medical Centre Hershey Pennsylvania USADepartment of Internal Medicine Dow University of Health Sciences Karachi PakistanDepartment of Internal Medicine Dow University of Health Sciences Karachi PakistanDepartment of Internal Medicine Cooper University Hospital Camden New Jersey USADepartment of Internal Medicine Cooper University Hospital Camden New Jersey USADepartment of Internal Medicine Indiana University Southwest New Albany Indiana USAGastroenterology & Hepatology The University of Kansas School of Medicine Kansas City Kansas USACooper Medical School of Rowan University Camden New Jersey USADepartment of Gastroenterology Cooper University Hospital Camden New Jersey USACooper Medical School of Rowan University Camden New Jersey USAABSTRACT Introduction The quality of bowel preparation has a significant impact on the success of colonoscopy. Currently, osmotically balanced polyethylene glycol electrolyte (PEG‐E) solutions are most commonly used for bowel preparation. Recently, lubiprostone (LBP) has been considered a potentially effective adjunct to PEG. We conducted a meta‐analysis of randomized controlled trials (RCTs) to evaluate the safety and efficacy of LBP in bowel preparation for colonoscopy. Methods Following PRISMA guidelines, we systematically screened PubMed, Embase, Web of Science, and Cochrane Library for RCTs on LBP as an adjunct to PEG‐E for improving bowel preparation quality for colonoscopy. Statistical analysis was performed on RevMan, using a random‐effects model with the generic inverse variance method to address clinical heterogeneity; results were significant at p < 0.05. Outcomes were reported as relative risks and standard errors. Results This meta‐analysis included seven RCTs with 1206 patients. Adding LBP did not increase the likelihood of an excellent bowel preparation [RR = 1.28, 95% CI: 0.94–1.74, p = 0.12] or contribute to poor preparation [RR = 0.61, 95% CI: 0.36–1.04; p = 0.07]. It also did not affect procedure time [MD = −0.74, 95% CI: −2.91–1.43; p = 0.50], polyp detection rate [RR = 1.07, 95% CI: 0.90–1.26; p = 0.45], or adenoma detection rate [RR = 1.09, 95% CI: 0.75–1.57; p = 0.66]. Conclusion Our meta‐analysis found that LBP, explored as an adjunct to PEG‐E solutions for bowel preparation, offers no significant additive effect on preparation quality before colonoscopy.https://doi.org/10.1002/jgh3.70186bowel preparationcolon cancer diagnosticscolon cancer preventioncolon cancer screeningcolon cancer therapeuticscolonoscopy
spellingShingle Fariha Hasan
Muhammad Shahzil
Ayesha Liaquat
Fatima Farooqi
Avneet Singh
Alexander Garcia
Muhammad Yafaa Naveed Chaudhary
Dushyant Singh Dahiya
Tanay‐Veer Gandhi
Andrew Alabd
Rachel Frank
Assessment of Lubiprostone as an Adjunct Therapy for Bowel Preparation in Colonoscopy: A Meta‐Analysis of Randomized Controlled Trials
JGH Open
bowel preparation
colon cancer diagnostics
colon cancer prevention
colon cancer screening
colon cancer therapeutics
colonoscopy
title Assessment of Lubiprostone as an Adjunct Therapy for Bowel Preparation in Colonoscopy: A Meta‐Analysis of Randomized Controlled Trials
title_full Assessment of Lubiprostone as an Adjunct Therapy for Bowel Preparation in Colonoscopy: A Meta‐Analysis of Randomized Controlled Trials
title_fullStr Assessment of Lubiprostone as an Adjunct Therapy for Bowel Preparation in Colonoscopy: A Meta‐Analysis of Randomized Controlled Trials
title_full_unstemmed Assessment of Lubiprostone as an Adjunct Therapy for Bowel Preparation in Colonoscopy: A Meta‐Analysis of Randomized Controlled Trials
title_short Assessment of Lubiprostone as an Adjunct Therapy for Bowel Preparation in Colonoscopy: A Meta‐Analysis of Randomized Controlled Trials
title_sort assessment of lubiprostone as an adjunct therapy for bowel preparation in colonoscopy a meta analysis of randomized controlled trials
topic bowel preparation
colon cancer diagnostics
colon cancer prevention
colon cancer screening
colon cancer therapeutics
colonoscopy
url https://doi.org/10.1002/jgh3.70186
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