Endoscopy 2019; 51(04): S151
DOI: 10.1055/s-0039-1681616
ESGE Days 2019 ePoster podium presentations
Friday, April 5, 2019 14:00 – 14:30: Bowel cleansing 3 ePoster Podium 1
Georg Thieme Verlag KG Stuttgart · New York

HIGH-QUALITY COLON CLEANSING IMPROVES SEGMENTAL POLYP AND ADENOMA DETECTION RATES: POST HOC ANALYSIS OF RANDOMISED CLINICAL TRIALS USING THE BOSTON BOWEL PREPARATION SCALE

C Hassan
1   Gastroenterology and Endoscopic Unit, Ospedale Nuovo Regina Margherita, Roma, Italy
,
J Halonen
2   Medical Affairs, Norgine, Harefield, United Kingdom
,
J Manning
3   Borders General Hospital, Berwickshire, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available ateRef
 
 

    Aims:

    Successful colon cleansing is defined as a segmental score of 2 or higher on the Boston Bowel Preparation Scale (BBPS). The additional clinical value of high-quality cleansing (BBPS 3) is subject for debate. This post hoc analysis of three randomised phase 3 clinical trials assessed the segmental lesion detection rates in the right colon at variable BBPS scores.

    Methods:

    Three similarly designed phase 3 trials assessed the efficacy and safety of 1L NER1006 versus standard bowel preparations. Polyps and adenomas were detected by site endoscopists as per local practice while cleansing assessment was standardised with treatment-blinded central readers using the validated BBPS. This pooled analysis assessed the right colon polyp (PDR) and adenoma (ADR) detection rates versus attained right colon cleansing quality. 1-sided t-tests assuming unequal variance compared the relative lesion detection rates versus the high-quality score BBPS 3.

    Results:

    A total of 1749 patients were included: BBPS 3 (n = 284), BBPS 2 (n = 1192), BBPS 1 (n = 210) and BBPS 0 (n = 63). BBPS 3 in the right colon was associated with a significantly higher PDR than BBPS 2 (23.6% vs. 17.2%; P = 0.010), BBPS 1 (23.6% vs. 15.2%; P = 0.009) and BBPS 0 (23.6% vs. 4.8%; P < 0.001). BBPS 3 in the right colon was also associated with a significantly higher ADR than BBPS 2 (14.8% vs. 10.9%; P = 0.046) and BBPS 0 (14.8% vs. 4.8%; P = 0.002). BBPS 1 had a numerically smaller ADR than BBPS 3 and BBPS 2.

    Conclusions:

    With a strictly assessed cleansing quality using the BBPS, higher PDR and ADR were obtained with high-quality versus adequate only right colon cleansing. As expected, high-quality right colon cleansing also enabled significantly greater PDR and ADR than failed cleansing. These findings encourage endoscopists to prioritise cleansing efficacy when selecting bowel preparations for their patients.