P306 Efficacy and tolerance of sodium picosulfate preparation in bowel Magnetic Resonance Imaging in Crohn’s disease
Juif, L.(1);Calame, P.(1);Chausset, C.(1);Koch, S.(1);Briot, C.(2);De Billy, M.(1);Vuitton, L.(1);
(1)chru jean minjoz, Doubs, Besancon, France;(2)Ch Haute saone, Doubs, Besancon, France;
Polyethylene glycol (PEG) is one of the most commonly used bowel preparation for magnetic resonance imaging (MRI) in Crohn’s Disease (CD). Sodium picosulfate (Pico) is a low volume bowel preparation known for its efficacy and higher tolerability for colonoscopy. No study has to date evaluated tolerance and efficacy of Pico preparations for MRI in CD. Aim : To assess for the first time the efficacy and tolerance of Pico preparation compared to PEG preparation for bowel MRI in CD.
The study took place in a French university hospital. To assess the efficacy of low volume preparations compared to PEG, we selected consecutive bowel MRI from January to June, 2017 prepared with PEG formulas, and consecutive MRI from January 2020 to June 2020 prepared with low-volume Pico formula.The sample size was calculated to assess the non-inferiority of Pico preparation vs PEG. The efficacy endpoint was the quality of bowel distention on a 5 points scale and by visual analog scale (VAS) by two independent readers. To study Pico preparation tolerability, we performed a prospective survey in CD patients undergoing MRI from October 2020 to August 2021. Patients completed a self-administered validated questionnaire on tolerability and a VAS.
In the efficacy study,84 MRIs were analysed (42 in each PEG and Pico group). There was no significant difference between PEG and Pico preparation regarding jejunum and ileum distention on the 5 points quality scale. Moreover, we did not find significant difference between PEG and Pico regarding overall quality in the VAS (8.1 ± 1.4 in PEG group, vs 8.7 ± 1.2 in Pico group, by reader 1 (p= 0.125); 6.35 ± 1 in PEG group, 6.5 ± 1 in Pico group by reader 2 (p=0.298)) with a moderate but significant correlation rate between the two readers (r= 0.45; p<0.001). There was no significant difference regarding ileal diameter between the two preparations with a moderate correlation rate between the two readers (r=0.41; p<0.01). In the prospective study, 38 patients participated in the survey. The bowel preparation intake was completefor 94.7% of the patients. The mean tolerance was 6.84/10. Overall, 81.6% of patients were willing to take the same preparation again.
The study assessed Pico preparation non-inferiority to PEG preparation for small bowel MRI and confirmed low volume bowel preparations good tolerability profile. This suggests that low-volume preparations could be more widely implemented in clinical practice for small bowel imaging in chronic inflammatory bowel disease and thus improve follow-up acceptance.