Akram Umar, Ahmad Eeman, Ahmed Shahzaib, Nadeem Zain Ali, Raza Muhammad Ahmed, Fatima Eeshal, Hassan Syed Adeel, Chaudhry Ahtshamullah, Bharadwaj Hareesha Rishab, Tariq Muhammad Arslan, Altaf Faryal, Qureshi Zaheer
Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan.
Department of Medicine, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan.
Clin Endosc. 2025 Sep 1. doi: 10.5946/ce.2025.073.
BACKGROUND/AIMS: The effectiveness of colonoscopy largely depends on the quality of bowel preparation. Polyethylene glycol (PEG) is commonly used but has certain limitations. This review evaluates whether combining PEG with linaclotide improves preparation efficacy and safety compared with PEG alone.
A search was conducted in Medline, Embase, and ClinicalTrials.gov up to October 2024. Only randomized controlled trials comparing PEG combined with linaclotide versus PEG alone and reporting adenoma detection rates (ADR) or polyp detection rates (PDR) were included. Mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were reported.
A total of eight studies, including 3,071 participants, were included. Pooled analysis indicated that PEG combined with linaclotide was significantly associated with a higher ADR (RR, 1.15; 95% CI, 1.03-1.28), higher Boston bowel preparation scale score (MD, 0.31; 95% CI, 0.02-0.61), and greater willingness to repeat colonoscopy (RR, 1.16; 95% CI, 1.08-1.24). Although PDR (RR, 1.05; 95% CI, 0.89-1.24) was numerically higher in the intervention group, the difference was not statistically significant. Additionally, the intervention significantly reduced the incidence of nausea, vomiting, bloating, and abdominal pain.
PEG combined with linaclotide is a safe alternative to PEG alone, improving ADR, bowel preparation quality, and patient comfort.
背景/目的：结肠镜检查的有效性很大程度上取决于肠道准备的质量。聚乙二醇（PEG）是常用的，但有一定局限性。本综述评估与单独使用PEG相比，PEG联合利那洛肽是否能提高准备效果和安全性。
截至2024年10月，在Medline、Embase和ClinicalTrials.gov上进行了检索。仅纳入比较PEG联合利那洛肽与单独使用PEG并报告腺瘤检出率（ADR）或息肉检出率（PDR）的随机对照试验。报告了具有95%置信区间（CI）的平均差（MD）和风险比（RR）。
共纳入8项研究，包括3071名参与者。汇总分析表明，PEG联合利那洛肽与更高的ADR（RR，1.15；95%CI，1.03 - 1.28）、更高的波士顿肠道准备量表评分（MD，0.31；95%CI，0.02 - 0.61）以及更高的重复结肠镜检查意愿（RR，1.16；95%CI，1.08 - 1.24）显著相关。虽然干预组的PDR（RR，1.05；95%CI，0.89 - 1.24）在数值上更高，但差异无统计学意义。此外，该干预显著降低了恶心、呕吐、腹胀和腹痛的发生率。
PEG联合利那洛肽是单独使用PEG的安全替代方案，可提高ADR、肠道准备质量和患者舒适度。
