MiraLAX vs. Golytely: Is There a Significant Difference in the Adenoma Detection Rate?

Aliment Pharmacol Ther. 2011 Oct;34(7):775-82. doi: 10.1111/j.1365-2036.2011.04795.x. Epub 2011 Aug 17.

Abstract

Background: In recent clinical trials (RCT) of bowel preparation, Golytely was more efficacious than MiraLAX. We hypothesised that there is a difference in adenoma detection between Golytely and MiraLAX.

Aims: To compare the adenoma detection rate (ADR) between these bowel preparations, and to identify independent predictors of bowel preparation quality and adenoma detection.

Methods: This was a post hoc analysis of an RCT that assessed efficacy and patient tolerability of Golytely vs. MiraLAX/Gatorade in average risk screening colonoscopy patients. Bowel preparation quality was measured with the Boston Bowel Preparation Scale (BBPS). An excellent/good equivalent BBPS score was defined as ≥ 7. Polyp pathology review was performed. ADR was defined as the proportion of colonoscopies with an adenoma. Univariate and multivariate analyses were conducted.

Results: One hundred and ninety patients were prospectively enrolled (87 MiraLAX, 103 Golytely). Golytely had a higher rate of a BBPS score ≥ 7 (82.5% vs. MiraLAX 67.8%, P=0.02). The ADR in the Golytely cohort was 26.2% (27/103), and was 16.1% (14/87) for MiraLAX (P = 0.091). On multivariate analyses, Golytely was 2.13 × more likely to be associated with a BBPS ≥ 7 (95% CI 1.05-4.32, P = 0.04) and 2.28 × more likely to be associated with adenoma detection (95% CI 1.05-4.98, P = 0.04) than MiraLAX.

Conclusions: Golytely was more efficacious than MiraLAX in bowel cleansing, and was independently associated with both bowel prep quality (BBPS ≥ 7) and higher adenoma detection. Golytely should be used as first line for bowel prep for colonoscopy. Studies with larger populations are needed to confirm these results.

Publication types

  • Comparative Study

MeSH terms

  • Adenoma / diagnosis*
  • Age Factors
  • Aged
  • Colonoscopy / methods*
  • Colorectal Neoplasms / diagnosis*
  • Electrolytes*
  • Female
  • Humans
  • Male
  • Mass Screening / methods
  • Middle Aged
  • Multivariate Analysis
  • Polyethylene Glycols*
  • Preoperative Care / methods
  • Randomized Controlled Trials as Topic
  • Retrospective Studies
  • Solvents*

Substances

  • Electrolytes
  • Golytely
  • Solvents
  • Polyethylene Glycols