More Young Adults Detected With 3+ Adenomas After Bowel Preparation with 1L Polyethylene Glycol Ner1006 Versus 2L Polyethylene Glycol or Oral Sulfate Solution

Aims The prevalence of colorectal adenomas is age-dependent, with patients aged ≥60 years mostly affected. Young adults aged ≤50 years have recently been identified as potentially at increased risk of developing colorectal adenomas and colorectal cancer. Clinical guidelines recommend shorter surveillance periods for patients detected with three or more adenomas[ ¹ ]. We analysed whether 1L polyethylene (PEG)-based NER1006 can allow endoscopists to detect more adenomas in young adults than 2LPEG/OSS.

Methods Analysis of the combined overnight split-dosing arms (NER1006/NER1006 versus 2LPEG/OSS) of the phase 3 clinical trials MORA and NOCT [ ² ] ^, [ ³ ]. Included patients aged 18-49 years and had documented polyp and adenoma counts in the overall colon and right colon, assessed by the site endoscopists. Patients with three or more adenomas (ADR3+) in the overall and at least one adenoma in the right colon (rADR) were assessed per combined treatment. Similarly, the mean number of adenomas per patient for both the overall (MAP) and right colon (rMAP) were also analysed. Statistical comparisons used the 1-sided t-test.

Results A total of 216 patients (NER1006: 96 and 2LPEG/OSS: 120) were included. NER1006 showed greater detection rates of ADR3+ (4.2 % [4/96] versus 0 % [0/120]; P = 0.012), and rADR (6.3 % [6/96] versus 1.7 % [2/120]; P = 0.038) than 2LPEG/OSS ([Table]). NER1006 also enabled a greater MAP (0.35 (0.14, 0.57) versus 0.18 (0.11, 0.24); P = 0.044) and rMAP (0.08 (0.01, 0.15) versus 0.02 (-0.01, 0.04); P = 0.026) than 2LPEG/OSS.

Conclusions Bowel preparation with NER1006 allowed detection of more patients with adenomas and also more adenomas per patient in young adults, compared to 2LPEG/OSS.

Table: Adenoma detection in patients aged 18-49 years.

	NER1006	2LPEG/OSS	1-sided p-value
ADR3+: Patients with at least three adenomas in the overall colon, % (n/N)	4.2 % (4/96)	0 % (0/120)	0.012
rADR: Patients with at least one adenoma in the right colon, % (n/N)	6.3 % (6/96)	1.7 % (2/120)	0.038
MAP: Number of adenomas per patient, mean (95 % Confidence Interval)	0.35 (0.14, 0.57)	0.18 (0.11, 0.24)	0.044
rMAP: Number of right colon adenomas per patient, mean (95 % Confidence Interval)	0.08 (0.01, 0.15)	0.02 (-0.01, 0.04)	0.026

Citation: Álvarez-González MA, Clayton L eP199 MORE YOUNG ADULTS DETECTED WITH 3+ ADENOMAS AFTER BOWEL PREPARATION WITH 1L POLYETHYLENE GLYCOL NER1006 VERSUS 2L POLYETHYLENE GLYCOL OR ORAL SULFATE SOLUTION. Endoscopy 2021; 53: S163.

• References:

• 1 Hassan C. et al, Endoscopy 2020; Aug; 53 (08) 687-700.
• 2 Bisschops R. , et al, Endoscopy 2019; Jan; 51 (01) 60-72.
• 3 DeMicco MP. , et al, Gastrointest Endosc 2018; Mar; 87 (03) 677-687.e3.

Publication History

Article published online:
19 March 2021