Evidence map›Paper›PMID 40528061›Full record

SynthesisInternational journal of colorectal disease2025

Combined linaclotide and polyethylene glycol electrolyte for colonoscopy preparation: a network meta-analysis of 14 randomized controlled trials.

Mohamed S Elgendy, Islam Rajab, Qasi Najah, Mohamed A Faheem, Omar K Elsawy, Hosam I Taha, Mariam Elewidi, Abdalhakim Shubietah, Dhruv Patel, Alisa Farokhian and 2 more

Erratum issuedAbstract readNetwork Meta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Mohamed S Elgendy *Faculty of Medicine, Tanta University, Tanta, Gharbia, Egypt. dr.elgendy.mo@gmail.com.ORCID http://orcid.org/0000-0003-3080-2875
Islam Rajab *Internal Medicine Department, St Joseph University Medical Center, Paterson, NJ, USA.ORCID http://orcid.org/0009-0003-6539-0417
Qasi NajahFaculty of Medicine, Al Margeb University, Al Khums, Murqub, Libya.ORCID http://orcid.org/0000-0002-0460-507X
Mohamed A FaheemFaculty of Medicine, Tanta University, Tanta, Gharbia, Egypt.ORCID http://orcid.org/0009-0009-0767-1070
Omar K ElsawyFaculty of Medicine, Tanta University, Tanta, Gharbia, Egypt.ORCID http://orcid.org/0009-0000-5028-904X
Hosam I TahaFaculty of Medicine, Tanta University, Tanta, Gharbia, Egypt.ORCID http://orcid.org/0009-0008-9192-4175
Mariam ElewidiFaculty of Medicine, Tanta University, Tanta, Gharbia, Egypt.ORCID http://orcid.org/0009-0005-8144-9962
Abdalhakim ShubietahInternal Medicine Department, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.ORCID http://orcid.org/0000-0002-8300-0262
Dhruv PatelGastroenterology and Hepatology, St. Joseph's University Medical Center, Paterson, NJ, USA.
Alisa FarokhianGastroenterology and Hepatology, St. Joseph's University Medical Center, Paterson, NJ, USA.ORCID http://orcid.org/0000-0001-8266-5003
Mohamed Abuelazm *Faculty of Medicine, Tanta University, Tanta, Gharbia, Egypt.ORCID http://orcid.org/0000-0002-2514-0689
Walid Baddoura *Gastroenterology and Hepatology, St. Joseph's University Medical Center, Paterson, NJ, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRecent evidence supports linaclotide (Lin) for colonoscopy preparation. This network meta-analysis evaluates the combination of different pill numbers of Lin with polyethylene glycol (PEG) (high and low volumes in liters (L)) for bowel cleansing.

methodsThis systematic review and frequentist network meta-analysis, conducted in October 2024, assessed randomized controlled trials (RCTs) from Scopus, PubMed, Cochrane, WOS, and Embase. Risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI) were calculated for categorical and continuous outcomes. PROSPERO ID: CRD42024618272.

resultsFourteen RCTs with 4,764 participants showed that total Boston Bowel Preparation Scale improved significantly with 2L PEG + 2Lin (MD = 2.03, 95%CI: [0.30:3.76], P = 0.0217), 3L-PEG + 3Lin (MD = 1.30, 95%CI: [0.42:2.18], P = 0.0038), and 4L-PEG (MD = 1.11, 95%CI: 0.23-1.98, P = 0.0129). Adenoma detection was highest with 3L-PEG + 3Lin (RR = 1.60, 95%CI: [1.05:2.43], P = 0.0280), while polyp detection improved with 2L PEG + 3Lin (RR = 1.72, 95%CI: [1.13:2.62], P = 0.0114) and 3L-PEG + 3Lin (RR = 1.33, 95%CI: [1.00:1.77], P = 0.0505). Procedure times were significantly reduced with 3L-PEG + 3Lin (MD = -4.6, 95%CI: [-6.24:-3.24], P < 0.0001), 3L-PEG + 1Lin (P = 0.035), and 4L-PEG (P < 0.01). Abdominal pain and abdominal bloating decreased with 2L PEG + 1Lin (P < 0.01) and 2L PEG + 2Lin (P = 0.021) but increased with 4L-PEG (P = 0.0178).

conclusionsCombining PEG with Lin improves bowel cleanliness compared to 3L-PEG, with 2L PEG + 2Lin being the most effective and well-tolerated. Despite some heterogeneity, the findings suggest that adding Lin may enhance bowel preparation with comparable safety, warranting consideration of individual patient factors.

Indexed as

CatharticsColonoscopyElectrolytesPeptidesPolyethylene GlycolsHumansRandomized Controlled Trials as TopicCatharticsElectrolyteslinaclotidePeptidesPolyethylene GlycolsColonoscopyColorectal cancer screeningEndoscopic bowel cleansingMeta-analysisPolyp detection

Identifiers

PMID40528061
PMCPMC12174239

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.