Adequate and High-Quality Cleansing Success From Under 5 to at Least 13 Hours After Bowel Preparation Start With Same Day 1L Ner1006: Post Hoc Analysis

Aims Urgent colonoscopies within 8 hours of presentation may increase the diagnostic yield¹. Bowel preparations with sustained cleansing efficacy may help endoscopists examine more patients per day. We analysed if 1L polyethylene glycol (PEG) NER1006 could rapidly attain high-quality colon cleansing success and sustain it over a period of typical daily working hours.

Methods Analysis of 262 patients using same-day morning-only dosing with NER1006 in the randomized clinical trial MORA². Included adult patients had their colonoscopy within 13 hours from the start of the bowel preparation and overall cleansing quality assessed by site endoscopists using the validated Harefield Cleansing Scale (HCS). Success rates were calculated for overall adequate (HCS AB) and high-quality (HCS A; all segments stool free) cleansing. Patient quartiles (Q1-Q4) with similar samples sizes but differing time lapses from the start of the bowel preparation to the start of the colonoscopy were compared versus Q1 using a 2-sided t-test.

Results Time lapses ranged from 4.67 to 12.97 hours ([Table]). Patients with the shortest and the longest time lapses attained both adequate and high-quality cleansing success. Adequate cleansing success was comparable across quartiles Q1 (87.9 % (58/66)), Q2 (89.6 % (60/67); P = 0.762), Q3 (92.3 % (60/65); P = 0.400) and Q4 (95.3 % (61/64); P = 0.130). Substantial high-quality cleansing success was also attained in all quartiles, with similar rates across quartiles Q1 (69.7 % (46/66)), Q2 (67.2 % (45/67); P = 0.756) and Q3 (66.2 % (43/65); P = 0.667). A numerically lower rate was observed in Q4 (56.3 % (36/64); P = 0.114).

Conclusions Same-day morning-only dosing with NER1006 attained successful adequate and high-quality cleansing within 5 hours and up to at least 13 hours from the start of bowel preparation. These findings encourage further research into the diagnostic benefits of urgent colonoscopies and endoscopists to consider increasing their daily colonoscopy capacity.

Table Colon cleansing success in quartiles of patients.

Quartile	Q1	Q2	Q3	Q4
Time lapse after the start of bowel preparation, hours	4.67 - 7.28	7.30 - 8.50	8.52 - 9.53	9.55 – 12.97
Patients, % (n/N)	25.2 (66/262)	25.6 (67/262)	24.8 (65/262)	24.4 (64/262)
HCS Grade AB success, % (n/N); 2-sided P vs Q1	87.9 (58/66); P = 1.000	89.6 (60/67); P = 0.762	92.3 (60/65); P = 0.400	95.3 (61/64); P = 0.130
HCS Grade A success, % (n/N); 2-sided P vs Q1	69.7 (46/66); P = 1.000	67.2 (45/67); P = 0.756	66.2 (43/65); P = 0.667	56.3 (36/64); P = 0.114

Citation:Álvarez-González MA, Halonen J. eP288 ADEQUATE AND HIGH-QUALITY CLEANSING SUCCESS FROM UNDER 5 TO AT LEAST 13 HOURS AFTER BOWEL PREPARATION START WITH SAME DAY 1L NER1006: POST HOC ANALYSIS. Endoscopy 2021; 53: S192.

Publication History

Article published online:
19 March 2021

• References

• 1 Gastroenterol Am J.. 2005; ; 100 (11) 2395-2402.
• 2 Endoscopy. 2019; Jan; 51 (01) 60-72.