Trial Outcomes & Findings for Yoga and Bolus Lukewarm Saline as Rapid Colonoscopy Preparation (NCT NCT01547130)

NCT ID: NCT01547130

Last Updated: 2015-03-04

Results Overview

The primary endpoint was the "success" rate of the preparations. Preparation efficacy was evaluated by a single, blinded endoscopist (V.A.), who performed all of the colonoscopies. The evaluation involved the rating of six anatomical segments of the colon (rectum, sigmoid, descending colon, transverse colon, ascending colon and cecum) on the 5 point Arya Bowel Prep Scale (ABPS). Aggregating the segmental scores resulted in overall scores. Grade A was defined as a total overall score of 19-24, grade B as a score of 13-18, grade C as a score of 7-12, and grade D as a score of 0-6. Grade A or B preparation was considered "successes", while grade C or D was considered "failures." To assess the reliability of ABPS, we trained 4 gastroenterologists and 3 fellows.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

133 participants

Primary outcome timeframe

Within 48 hours of bowel preparation

Results posted on

2015-03-04

Participant Flow

This was a randomized, single-center, single-blinded (to the endoscopists) and active-control study. Patients undergoing elective colonoscopy between May 2008 and December 2010 were recruited. Location: Medical Clinic.

No events were recorded. None of the enrolled participants were excluded from the trial before assignment to groups. However, 14 no show ups for procedure were identified.

Participant milestones

Participant milestones
Measure
Shudh Colon Cleanse (SCC) Group
Patients will take a bolus intake of 8 oz. (240mL) to 16 oz. (480mL) of lukewarm saline water and perform yoga poses.
HalfLytely Colon Prep (HCP)
Patients followed the preparation method according to the manufacturer's standard instructions.
Overall Study
STARTED
74
73
Overall Study
COMPLETED
65
68
Overall Study
NOT COMPLETED
9
5

Reasons for withdrawal

Reasons for withdrawal
Measure
Shudh Colon Cleanse (SCC) Group
Patients will take a bolus intake of 8 oz. (240mL) to 16 oz. (480mL) of lukewarm saline water and perform yoga poses.
HalfLytely Colon Prep (HCP)
Patients followed the preparation method according to the manufacturer's standard instructions.
Overall Study
Lost to Follow-up
9
5

Baseline Characteristics

Yoga and Bolus Lukewarm Saline as Rapid Colonoscopy Preparation

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Shudh Colon Cleanse (SCC) Group
n=74 Participants
Patients will take a bolus intake of 8 oz. (240mL) to 16 oz. (480mL) of lukewarm saline water and perform yoga poses.
HalfLytely Colon Prep (HCP) Group
n=73 Participants
Patients followed the preparation method according to the manufacturer's standard instructions.
Total
n=147 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Categorical
Between 18 and 65 years
72 Participants
n=99 Participants
73 Participants
n=107 Participants
145 Participants
n=206 Participants
Age, Categorical
>=65 years
2 Participants
n=99 Participants
0 Participants
n=107 Participants
2 Participants
n=206 Participants
Age, Continuous
43.6 years
STANDARD_DEVIATION 10.5 • n=99 Participants
44.8 years
STANDARD_DEVIATION 10 • n=107 Participants
44.2 years
STANDARD_DEVIATION 10.2 • n=206 Participants
Sex: Female, Male
Female
48 Participants
n=99 Participants
43 Participants
n=107 Participants
91 Participants
n=206 Participants
Sex: Female, Male
Male
26 Participants
n=99 Participants
30 Participants
n=107 Participants
56 Participants
n=206 Participants
Region of Enrollment
United States
74 participants
n=99 Participants
73 participants
n=107 Participants
147 participants
n=206 Participants

PRIMARY outcome

Timeframe: Within 48 hours of bowel preparation

Population: The non-inferiority margin was set at -15%. This means the intervention will be considered non-inferior if the difference in success rates is less than 15%. The study was designed to have 90% power to establish non-inferiority when the two treatment groups are equivalent using a one-tailed test at the 5% significance level.

The primary endpoint was the "success" rate of the preparations. Preparation efficacy was evaluated by a single, blinded endoscopist (V.A.), who performed all of the colonoscopies. The evaluation involved the rating of six anatomical segments of the colon (rectum, sigmoid, descending colon, transverse colon, ascending colon and cecum) on the 5 point Arya Bowel Prep Scale (ABPS). Aggregating the segmental scores resulted in overall scores. Grade A was defined as a total overall score of 19-24, grade B as a score of 13-18, grade C as a score of 7-12, and grade D as a score of 0-6. Grade A or B preparation was considered "successes", while grade C or D was considered "failures." To assess the reliability of ABPS, we trained 4 gastroenterologists and 3 fellows.

Outcome measures

Outcome measures
Measure
Shudh Colon Cleanse (SCC) Group
n=65 Participants
Yoga contained a 32-oz plastic pitcher and 9-gm salt sachets (Iodine-free table salt - USP grade sodium chloride) for preparation of 0.9% saline (1 sachet in 32-oz lukewarm water (37.2-38.8 degrees Centigrade or 99-102 degrees Fahrenheit)), an instructional leaflet, and a DVD providing instructions of the bowel preparation process. Patients were instructed to fill the pitcher with 16-oz of hot water and 16-oz of room temperature water to reach the lukewarm temperature. Patients could add a twist of lemon if the solution was unpalatable to them.
HalfLytely Colon Prep (HCP) Group
n=68 Participants
Patients in the HCP group followed the preparation method according to the manufacturer's standard instructions. Patients were instructed to stay on clear liquids the entire day before the colonoscopy. Two tablets of bisacodyl delayed-release tablets with water were taken at around 1:00 pm. Patients were instructed to start drinking the solution after a bowel movement or around 7 pm if no bowel activity occurred. They were instructed to sip all of the solution at a rate of 8 oz. every 10 minutes.
Efficacy of Large Bowel Cleansing as Assessed by the Physician Performing the Colonoscopy
18.69 Score
Standard Deviation 5.34
20.1 Score
Standard Deviation 3.51

SECONDARY outcome

Timeframe: Upto 24 weeks

Population: All subjects enrolled and completed the bowel preparation. .

Patients completed a symptom questionnaire where they rated solution palatability of their assigned prep on a 1-5 Likert scale. A rating of more than 3 was considered as "Palatable".

Outcome measures

Outcome measures
Measure
Shudh Colon Cleanse (SCC) Group
n=65 Participants
Yoga contained a 32-oz plastic pitcher and 9-gm salt sachets (Iodine-free table salt - USP grade sodium chloride) for preparation of 0.9% saline (1 sachet in 32-oz lukewarm water (37.2-38.8 degrees Centigrade or 99-102 degrees Fahrenheit)), an instructional leaflet, and a DVD providing instructions of the bowel preparation process. Patients were instructed to fill the pitcher with 16-oz of hot water and 16-oz of room temperature water to reach the lukewarm temperature. Patients could add a twist of lemon if the solution was unpalatable to them.
HalfLytely Colon Prep (HCP) Group
n=68 Participants
Patients in the HCP group followed the preparation method according to the manufacturer's standard instructions. Patients were instructed to stay on clear liquids the entire day before the colonoscopy. Two tablets of bisacodyl delayed-release tablets with water were taken at around 1:00 pm. Patients were instructed to start drinking the solution after a bowel movement or around 7 pm if no bowel activity occurred. They were instructed to sip all of the solution at a rate of 8 oz. every 10 minutes.
Palatability of Bowel Prep
48 participants
38 participants

SECONDARY outcome

Timeframe: Upto 24 weeks

Population: Patients completed a questionnaire where they rated willingness to repeat the preps on a 1-5 Likert scale.

Subjects rated the SCC as "Willingness to repeat the same prep in future"

Outcome measures

Outcome measures
Measure
Shudh Colon Cleanse (SCC) Group
n=65 Participants
Yoga contained a 32-oz plastic pitcher and 9-gm salt sachets (Iodine-free table salt - USP grade sodium chloride) for preparation of 0.9% saline (1 sachet in 32-oz lukewarm water (37.2-38.8 degrees Centigrade or 99-102 degrees Fahrenheit)), an instructional leaflet, and a DVD providing instructions of the bowel preparation process. Patients were instructed to fill the pitcher with 16-oz of hot water and 16-oz of room temperature water to reach the lukewarm temperature. Patients could add a twist of lemon if the solution was unpalatable to them.
HalfLytely Colon Prep (HCP) Group
n=68 Participants
Patients in the HCP group followed the preparation method according to the manufacturer's standard instructions. Patients were instructed to stay on clear liquids the entire day before the colonoscopy. Two tablets of bisacodyl delayed-release tablets with water were taken at around 1:00 pm. Patients were instructed to start drinking the solution after a bowel movement or around 7 pm if no bowel activity occurred. They were instructed to sip all of the solution at a rate of 8 oz. every 10 minutes.
Subjective Grading by Patients on Willingness to Repeat the Large Bowel Preparation.
44 participants
40 participants

SECONDARY outcome

Timeframe: Upto 24 weeks

Population: Patients from both groups reported adverse events in a symptom questionnaire.

Patients from both groups reported adverse events in a symptom questionnaire.

Outcome measures

Outcome measures
Measure
Shudh Colon Cleanse (SCC) Group
n=65 Participants
Yoga contained a 32-oz plastic pitcher and 9-gm salt sachets (Iodine-free table salt - USP grade sodium chloride) for preparation of 0.9% saline (1 sachet in 32-oz lukewarm water (37.2-38.8 degrees Centigrade or 99-102 degrees Fahrenheit)), an instructional leaflet, and a DVD providing instructions of the bowel preparation process. Patients were instructed to fill the pitcher with 16-oz of hot water and 16-oz of room temperature water to reach the lukewarm temperature. Patients could add a twist of lemon if the solution was unpalatable to them.
HalfLytely Colon Prep (HCP) Group
n=68 Participants
Patients in the HCP group followed the preparation method according to the manufacturer's standard instructions. Patients were instructed to stay on clear liquids the entire day before the colonoscopy. Two tablets of bisacodyl delayed-release tablets with water were taken at around 1:00 pm. Patients were instructed to start drinking the solution after a bowel movement or around 7 pm if no bowel activity occurred. They were instructed to sip all of the solution at a rate of 8 oz. every 10 minutes.
Patient-reported Adverse Events.
32 participants
46 participants

SECONDARY outcome

Timeframe: Upto 24 weeks

Population: Patients in both groups were provided with a questionnaire to record the total time required from start of assigned prep to completion of the prep.

Patients in both groups were provided with a questionnaire to record the total time required from start of assigned prep to completion of the prep.

Outcome measures

Outcome measures
Measure
Shudh Colon Cleanse (SCC) Group
n=65 Participants
Yoga contained a 32-oz plastic pitcher and 9-gm salt sachets (Iodine-free table salt - USP grade sodium chloride) for preparation of 0.9% saline (1 sachet in 32-oz lukewarm water (37.2-38.8 degrees Centigrade or 99-102 degrees Fahrenheit)), an instructional leaflet, and a DVD providing instructions of the bowel preparation process. Patients were instructed to fill the pitcher with 16-oz of hot water and 16-oz of room temperature water to reach the lukewarm temperature. Patients could add a twist of lemon if the solution was unpalatable to them.
HalfLytely Colon Prep (HCP) Group
n=68 Participants
Patients in the HCP group followed the preparation method according to the manufacturer's standard instructions. Patients were instructed to stay on clear liquids the entire day before the colonoscopy. Two tablets of bisacodyl delayed-release tablets with water were taken at around 1:00 pm. Patients were instructed to start drinking the solution after a bowel movement or around 7 pm if no bowel activity occurred. They were instructed to sip all of the solution at a rate of 8 oz. every 10 minutes.
Total Preparation Time
1.9 hours
Interval 1.25 to 4.0
10.9 hours
Interval 4.0 to 18.0

Adverse Events

Shudh Colon Cleanse (SCC) Group

Serious events: 0 serious events
Other events: 25 other events
Deaths: 0 deaths

HalfLytely Colon Prep (HCP) Group

Serious events: 0 serious events
Other events: 28 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Shudh Colon Cleanse (SCC) Group
n=65 participants at risk
Patients will take a bolus intake of 8 oz. (240mL) to 16 oz. (480mL) of lukewarm saline water and perform yoga poses.
HalfLytely Colon Prep (HCP) Group
n=68 participants at risk
Patients followed the preparation method according to the manufacturer's standard instructions.
Gastrointestinal disorders
Nausea
38.5%
25/65 • Same day
41.2%
28/68 • Same day
Gastrointestinal disorders
Vomiting
4.6%
3/65 • Same day
17.6%
12/68 • Same day

Additional Information

Dr Vijaypal Arya

Wyckoff Heights Medical Center

Phone: 718-326-0400

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place