Hasan Fariha, Shahzil Muhammad, Liaquat Ayesha, Farooqi Fatima, Singh Avneet, Garcia Alexander, Chaudhary Muhammad Yafaa Naveed, Dahiya Dushyant Singh, Gandhi Tanay-Veer, Alabd Andrew, Frank Rachel
Department of Internal Medicine Cooper University Hospital Camden New Jersey USA.
Penn State Health Milton S. Hershey Medical Centre Hershey Pennsylvania USA.
JGH Open. 2025 May 15;9(5):e70186. doi: 10.1002/jgh3.70186. eCollection 2025 May.
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.
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 < 0.05. Outcomes were reported as relative risks and standard errors.
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, = 0.12] or contribute to poor preparation [RR = 0.61, 95% CI: 0.36-1.04; = 0.07]. It also did not affect procedure time [MD = -0.74, 95% CI: -2.91-1.43; = 0.50], polyp detection rate [RR = 1.07, 95% CI: 0.90-1.26; = 0.45], or adenoma detection rate [RR = 1.09, 95% CI: 0.75-1.57; = 0.66].
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.
肠道准备的质量对结肠镜检查的成功有着重大影响。目前，渗透平衡的聚乙二醇电解质（PEG-E）溶液是肠道准备最常用的方法。最近，鲁比前列酮（LBP）被认为是PEG的一种潜在有效辅助药物。我们进行了一项随机对照试验（RCT）的荟萃分析，以评估LBP在结肠镜检查肠道准备中的安全性和有效性。
按照PRISMA指南，我们系统地在PubMed、Embase、Web of Science和Cochrane图书馆中筛选关于LBP作为PEG-E辅助药物以提高结肠镜检查肠道准备质量的RCT。使用RevMan进行统计分析，采用随机效应模型和通用逆方差方法处理临床异质性；结果在<0.05时具有显著性。结果以相对风险和标准误差报告。
该荟萃分析纳入了7项RCT，共1206例患者。添加LBP并未增加肠道准备优秀的可能性[RR = 1.28，95%CI：0.94 - 1.74，P = 0.12]，也未导致准备不佳[RR = 0.61，95%CI：0.36 - 1.04；P = 0.07]。它也不影响操作时间[MD = -0.74，95%CI：-2.91 - 1.43；P = 0.50]、息肉检出率[RR = 1.07，95%CI：0.90 - 1.26；P = 0.45]或腺瘤检出率[RR = 1.09，95%CI：0.75 - 1.57；P = 0.66]。
我们的荟萃分析发现，作为PEG-E溶液肠道准备的辅助药物进行研究的LBP，对结肠镜检查前的准备质量没有显著的附加作用。
