Clinical Epidemiology (Apr 2022)
The Effect of Prucalopride on the Completion Rate and Polyp Detection Rate of Colon Capsule Endoscopies
Abstract
Ulrik Deding,1,2 Lasse Kaalby,1,2 Gunnar Baatrup,1,2 Morten Kobaek-Larsen,1,2 Marianne Kirstine Thygesen,1,2 Owen Epstein,3 Thomas Bjørsum-Meyer1,2 1Department of Surgery, Odense University Hospital, Svendborg, Denmark; 2Department of Clinical Research, University of Southern Denmark, Odense, Denmark; 3Institute for Minimally Invasive Gastroenterology, Royal Free London NHS Foundation Trust, London, UKCorrespondence: Ulrik Deding, Department of Surgery, Odense University Hospital, Baagøes Allé 15, SVB Bygning 13.02, Svendborg, 5700, Denmark, Tel +45 42574243, Email [email protected]; [email protected]: To investigate whether the prokinetic prucalopride increases the completion rate of colon capsule endoscopy (CCE). Secondary outcomes included demographic distribution, polyp detection rate (PDR), distribution of Leighton–Rex grade, and adverse events.Patients and Methods: In a nested cohort within the CareForColon2015 trial, a subgroup of 406 individuals underwent CCE in 2021. The first half (control) received the standard bowel preparation and the second half (prucalopride) was supplemented with 2 mg of prucalopride. Transit times and bowel preparations were analyzed and completion rates calculated as those having timely transit and acceptable bowel cleanliness. Major adverse events were recorded continuously and minor adverse events were quantified from questionnaires.Results: The group demographics were homogenous. The prevalence ratio for complete CCE was 1.32 (CI 95% 1.15; 1.53) in the prucalopride group compared to the control group. Completion rate was 74.9% in the prucalopride group and 56.7% in the control group. The proportions of acceptable bowel preparation and complete transits were higher in the prucalopride group. The mean CCE transit time was 2 hours and 8 minutes faster in the prucalopride group. The PDR was higher in the intervention group with 55.7% compared to 36.0% in the control group for polyps greater than 9 mm, whereas the groups’ PDRs were similar for small and diminutive polyps. In all, 589 polyps (mean 2.9) were found in the prucalopride group compared to 522 polyps (mean 2.6) in the control group.Conclusion: Prucalopride led to an increase in CCE completion rates. The proportions of complete transits and acceptable bowel preparations were higher in the prucalopride group. The PDR was higher in the prucalopride group compared to the control group. No major adverse events were identified. Nausea, diarrhea, headache and fatigue were more commonly reported in the prucalopride group.Keywords: Resolor, prokinetic, polyps, bowel preparation, Leighton–Rex, video capsule endoscopy
