Efficacy and tolerability of high and low-volume bowel preparation compared: A real-life single-blinded large-population study

Abstract Background: Low-volume (LV) preparations for colonoscopy have shown similar efficacy compared to high-volume (HV) ones in trials. However, real-life clinical outcomes data are lacking. Our aim was to assess patients’ free choice among HV preparations (4L polyethylene glycol, PEG) and LV (2L PEG plus bisacodyl) and to compare efficacy and tolerability. Methods: Consecutive outpatients referred for colonoscopy could choose either LV or HV preparation with schedules (day-before or split-dose) depending on their appointment time. Adequate bowel preparation according to Boston Bowel Preparation Scale, clinical outcomes and self-reported tolerability of HV and LV were blindly assessed.Results: 2,040 patients were enrolled and 1,815 (age 60.6 years, 50.2% men) finally included. LV was chosen by 52% of patients (50.8% of men, 54.9% of women). Split-dose schedule was more common with HV (44.7% vs. 38.2%, p=0.0055). HV and LV preparations showed similar adequate bowel preparation rates (89.2% vs. 86.6%, p=0.0983) but HV ones resulted higher in detection rates for polyps (PDR; OR 1.30, 95% CI 1.03–1.64, p=0.0254), adenomas (ADR; OR 1.28, 95% CI 0.99–1.65, p=0.0519) and advanced adenomas (AADR; OR 1.54, 95% CI 0.96–2.46, p= 0.0723) after adjustment for sex, age, indications. Visual Analogue Scale tolerability scored equally (7 [5-9]) but a ≥75% dose intake was more frequent with LV.Conclusions: in a real-life setting, LV preparation confirms similar efficacy and tolerability compared to HV. However, with higher PDR and a trend toward higher ADR and AADR, HV should still be considered the reference standard for clinical trials.

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Impact of low-volume versus standard-volume bowel preparation on participation in primary screening colonoscopy: a randomized health services study

10.26226/morressier.57c5383bd462b80296c9c202 ◽

2016 ◽

Author(s):

Małgorzata Pisera

Keyword(s):

Health Services ◽

Bowel Preparation ◽

Screening Colonoscopy ◽

Volume Versus ◽

Primary Screening ◽

Low Volume

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Faculty Opinions recommendation of Chronic urticaria and autoimmunity: associations found in a large population study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.14267049.15779175 ◽

2012 ◽

Author(s):

Riccardo Asero

Keyword(s):

Population Study ◽

Chronic Urticaria ◽

Large Population

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POS0675 THE COMPARATIVE 3-YEAR RETENTION RATE OF TARGETED-SYNTHETIC AND BIOLOGIC DRUGS FOR RHEUMATOID ARTHRITIS: REAL-LIFE DATA FROM THE ITALIAN GISEA REGISTRY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3557 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 582.1-582

Author(s):

E. G. Favalli ◽

F. Iannone ◽

E. Gremese ◽

R. Gorla ◽

R. Foti ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Adverse Events ◽

Retention Rate ◽

Large Population ◽

Real Life ◽

Mechanisms Of Action ◽

Biologic Drugs ◽

Real Life Setting ◽

Study Population ◽

Targeted Drug

Background:Long-term observational data on the real-life use of JAK inhibitors (JAKis) for rheumatoid arthritis (RA) and their comparison with biological drugs are still very limited. Large population-based registries have been increasingly used to investigate the performance of targeted drugs in a real-life setting.Objectives:The aim of this study is to evaluate and compare the 3-year retention rate of JAKis, TNF inhibitors (TNFis) and biologic drugs with other mechanisms of action (OMAs) in the large cohort of RA patients included in the Italian national GISEA registry.Methods:Data of all RA patients treated with targeted synthetic or biologic drugs were prospectively collected in the Italian multicentric GISEA registry. The analysis was limited to patients who started a first- or second-line targeted drug in the period after the first JAKi was marketed in Italy (1st December 2017). The 3-year retention rate was calculated by the Kaplan-Meier method and compared between different drug classes by a log-rank test. A descriptive analysis of reasons for discontinuation was performed.Results:The study population included 1027 RA patients (79.8% females, mean age [±SD] 56.9 [±13.5] years, mean disease duration 9.8 [±9] years, mean baseline SDAI 17.5 [±11.9], ACPA positive 67.4%, RF positive 62.7%) who received JAKis (baricitinib or tofacitinib, n=297), TNFis (n=365), or OMAs (n=365) as first or second targeted drug. Main baseline characteristics of study population were overall well balanced between treatment groups. Retention rate was numerically but not statistically higher (p=0.18) in patients treated with JAKis compared with TNFis or OMAs (80.6, 78.9 and 76.4% at 1 year and 73, 56.8 and 63.8% at 3 years, respectively) (Figure 1). Drug survival was significantly higher in patients receiving concomitant methotrexate (MTX) compared with monotherapy only in TNFis (66.8 vs 47.1%, p=0.04) but not in JAKis (76.1 vs 70.1%, p=0.54) and OMAs (66.1 vs 61.9%, p=0.41) group. Therapy was discontinued in a total of 211 patients because of ineffectiveness (n=107), adverse events (n=88), or compliance/other reasons (n=16). The most frequent reason for treatment withdrawal was ineffectiveness in both JAKis (n=30 out of 56) and TNFis (n=45 out of 74) groups, whereas OMAs were discontinued more frequently because of adverse events (n=41 out of 81).Conclusion:Our data confirmed in a real-life setting a favorable 3-year retention rate of all available targeted mechanisms of action for RA therapy. As expected, concomitant MTX significantly impacted persistence on therapy of TNFis only. Discontinuations of JAKis for adverse events were infrequent overall, confirming the safety profile observed in randomized clinical trials.Figure 1.Three-year retention rate by treatment groupDisclosure of Interests:None declared

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