Lubiprostone adjunct therapy improves bowel prep in colonoscopy

The use of lubiprostone as an adjunct therapy for bowel preparation results in better odds of excellent quality prep, with an acceptable safety profile, a study has shown.

A systematic review and meta-analysis was conducted to examine the effects of adjunct lubiprostone bowel prep on colonoscopies performance. The authors did a comprehensive search of PubMed, Embase, Cochrane, and Web of Science from inception until February 2025 for randomized controlled trials (RCTs) comparing lubiprostone adjunct therapy, bowel prep and control.

Data was analysed for polyp detection rates, bowel prep quality, colonoscopy duration, adverse events, and side effects using a random effects model. These data were presented using pooled odds ratio (OR) and mean differences (MD) with 95 percent confidence interval (CI).

Eight RCTs met the inclusion criteria, involving a total of 1,322 patients (657 in the lubiprostone group and 665 in the control group).

No significant difference was observed in polyp detection rate between groups (OR, 1.27, 95 percent CI, 0.92‒1.76; p=0.15; I², 0 percent). Participants in the lubiprostone group were more likely to have excellent bowel prep (OR, 2.25, 95 percent CI, 1.52‒3.33; p<0.0001; I², 41 percent) and less likely to have poor bowel prep (p=0.009) than those in the control group.

Duration of colonoscopy in minutes (p=0.17) and the odds of adverse events (p=0.22) were similar between the two groups.

“Bowel preparation is an essential part of the colonoscopy process, with inadequate or poor bowel preparation associated with decreased polyp detection,” the authors said.