Study on the efficacy and safety of linaclotide combined with polyethylene glycol for bowel preparation in patients with functional constipation
10.3760/cma.j.cn311367-20240131-00046
- VernacularTitle:利那洛肽联合聚乙二醇对功能性便秘患者肠道准备的效果及安全性研究
- Author:
Hanqing LI
1
;
Yukun LI
;
Xingsi QI
;
Peng ZHANG
;
Yanan YU
;
Zibin TIAN
Author Information
1. 青岛市城阳人民医院消化内科，青岛 266107
- Publication Type:Journal Article
- Keywords:
Linaclotide;
Functional constipation;
Intestinal preparation;
Polyethylene glycol
- From:
Chinese Journal of Digestion
2024;44(9):605-612
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of linaclotide(LIN) combined with polyethylene glycol(PEG) for bowel preparation in patients with functional constipation (FC).Methods:From August 1, 2022 to April 30, 2023, a total of 300 patients with FC (FC group) and 300 subjects with non-functional constipation (NFC, NFC group) undergoing colonoscopy at the Affiliated Hospital of Qingdao University were selected. According to simple random sampling method, both FC group and NFC group were divided into 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup, respectively, with 100 cases in each group and a total of 6 subgroups. All subjects were enrolled based on a random number table and received the corresponding bowel preparation protocols. The Ottawa bowel preparation score (OBPS) and the rate of adequate bowel preparation were calculated. Ordered logistic regression analysis was used to analyze the independent influencing factors of OBPS. The incidence of adverse events (such as bloating) and the repetition rate of regimen intention were analyzed. One-way ANOVA, least significant difference analysis, and chi-square test were used for statistical analysis.Results:The OBPS of the 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup in the FC group were 6.06±1.67, 3.86±2.20, and 4.06±2.03, respectively, while the OBPS of the 3 corresponding subgroups in the NFC group were 5.08±1.92, 3.42±2.04, and 3.63±1.93, respectively. The OBPS scores of the 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC group were lower than those of the 3 L PEG subgroup within the respective group, and the differences were statistically significant ( t=7.16, 7.55, 4.59, and 6.06; all P<0.001). The rates of adequate bowel preparation of the 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup in the FC group were 83.0% (78/94), 95.6% (87/91), and 96.8% (92/95), respectively, while the rates of adequate bowel preparation of the 3 subgroups in the NFC group were 88.0% (88/100), 96.9%(94/97), and 97.0%(96/99), respectively. The rates of adequate bowel preparation of 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC group were higher than those of the 3 L PEG subgroup in the respective group, and the differences were statistically significant( χ2=10.04, 7.64, 5.74, and 5.55, P=0.001, 0.008, 0.029, 0.029). The FC group was divided into 2 L PEG+ LIN compared to 3 L PEG+ LIN subgroup, as well as 3 L PEG+ LIN compared to 3 L PEG subgroup for ordinal logistic regression analysis, and the result showed that the bowel preparation regimen was an independent influencing factor for OBPS ( OR=0.940 and 3.072, 95% confidence interval 0.368 to 1.483 and 1.564 to 3.252; both P<0.001). The incidence of abdominal distension of the 3 L PEG subgroup in FC group and NFC group was higher than that of the 2 L PEG+ LIN subgroup in the respective group (11.7%(11/94) vs. 3.2%(3/95), 12.0%(12/100) vs. 4.0%(4/99)), and the differences were statistically significant( χ2=5.03 and 4.26, P=0.028 and 0.045). The repetition rates of regimen intention of the 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC groups were higher than that of the 3 L PEG subgroup in respective group (93.7%(89/95), 93.4%(85/91) vs. 80.9%(76/94); 92.9%(92/99), 92.8%(90/97) vs. 82.0%(82/100)), and the differences were statistically significant ( χ2=5.25, 8.70, 4.31, and 5.40; P=0.009, 0.015, 0.020, and 0.023). Conclusions:The 2 L PEG+ LIN regimen can effectively decrease OBPS, improve qualified rate of bowel preparation and repetition rate of regimen intention, and reduce adverse events and the amount of fluid intake, in order to improve the tolerance and compliance of patients. Therefore, the 2 L PEG+ LIN regimen is recommended as a bowel preparation for colonoscopy in patients with FC.
