PTH-030 Outcomes of hemospray use in peptic ulcer upper gastrointestinal bleeds: Outcomes from the hemospray registry

Mohamed Hussein, Durayd Alzoubaidi, Miguel Fraile, Jacobo Ortiz Fernandez-sordo, Krish Ragunath, Radu Rusu, John Dunn, Johannes Rey, Shraddha Gulati, Bu'Hussain Hayee, Selena Dixon, Sulleman Moreea (+19 others)
2019 Posters   unpublished
randomised clinical trials assessed the treatment-independent trends for overall colon cleansing quality versus overall colon lesion detection. Methods Three multi-centre phase 3 clinical trials compared the cleansing efficacy and safety of the 1L PEG NER1006 (PLENVU ® ) versus standard bowel preparations in patients aged 18-85 years. Treatment-blinded assessment of colon cleansing quality was performed by both site colonoscopists (SC; who also detected all lesions per local practice) and by
more » ... practice) and by central readers (CR). Two validated cleansing scales were used: the Harefield Cleansing Scale (HCS) and the Boston Bowel Preparation Scale (BBPS; only by CR). Patients with documented HCS cleansing grades D-A, overall BBPS scores 0-9, and overall colon lesion counts were included in this analysis. Logistic regression trends were fitted to polyp-(PDR) and adenoma (ADR) detection rates, using cleansing quality as a covariate. Results Out of 1,985 randomised patients, 1,749 patients were included (table 1). With site colonoscopists' HCS grades, the logistic regression for relative lesion detection demonstrated an odds ratio of 1.17, i.e. for each incremental increase in the HCS colon cleansing grade from D to A there was a 1.17 times increase in both PDR (P=0.009) and ADR (P=0.019). With central readers, the corresponding increase was 1.24 times for PDR (P=0.005) and 1.26 times for ADR (P=0.006). With central readers, each incremental increase in the successful BBPS scores 6-9 resulted in a 1.08 times increase in PDR (P<0.001) and 1.10 times increase in ADR (P<0.001) versus failing BBPS scores 0-5. Conclusions Adopting a better bowel preparation remains a good way to improve quality in colonoscopy. With both HCS and BBPS, an increased overall colon cleansing quality was associated with greater overall colon PDR and ADR across the full range from cleansing failures and up to high-quality cleansing. Abstract PTH-028 Table 1 Overall colon cleansing quality and relative lesion detection HCS Grade D-A assessed by site colonoscopists HCS Grade D-A assessed by central readers Overall BBPS Score 0-9 assessed by central readers Patients, N 1,749 1,749 1,749 Relative lesion detection, odds ratio (95% CI); P-value PDR 1.17 (1.
doi:10.1136/gutjnl-2019-bsgabstracts.55 fatcat:dwlymttosncxtb4zayteheszjm