Efficacy of mosapride citrate with polyethylene glycol solution for colonoscopy preparation

AIM：To evaluate the efficacy and safety of adjunctive mosapride citrate for bowel preparation before colonoscopy. METHODS：We conducted a randomized,double-blind, placebo-controlled study with mosapride in addition to polyethylene glycol（PEG）-electrolyte solution.Of 250 patients undergoing colonoscopy,124 were randomized to receive 2 L PEG plus 15 mg of mosapride citrate （mosapride group）,and 126 received 2 L PEG plus placebo（placebo group）.Patients completed a questionnaire reporting the acceptability and tolerability of the bowel preparation process.The efficacy of bowel preparation was assessed by colonoscopists using a 5-point scale based on Aronchick’s criteria.The primary end point was optimal bowel preparation rates（scores of excellent/good/fair vs poor/inadequate）. RESULTS：A total of 249 patients were included in the analysis.In the mosapride group,optimal bowel preparation rates were significantly higher in the left colon compared with the placebo group（78.2%vs 65.6%,P0.05）,but not in the right colon（76.5%vs 66.4%,P=0.08）.After excluding patients with severe constipation,there was a significant difference in bowel preparation in both the left and right colon（82.4%vs 66.7%,80.8%vs 67.5%,P0.05,P0.01）.The incidence of adverse events was similar in both groups. Among the subgroup who had previous colonoscopy experience,a significantly higher number of patients in the mosapride group felt that the current preparation was easier compared with patients in the placebo group（34/72 patients vs 24/74 patients,P0.05）. CONCLUSION：Mosapride citrate may be an effective and safe adjunct to PEG-electrolyte solution that leads to improved quality of bowel preparation,especially in patients without severe constipation.