Objective:

To compare the effectiveness and safety of linaclotide combined with polyethylene glycol (Lin + PEG) versus PEG alone for bowel preparation in elderly Chinese adults.

Approach:

• Study Selection: Randomized controlled trials (RCTs) comparing Lin + PEG with PEG alone in Chinese adults aged ≥60 years were identified through a comprehensive literature search.
• Data Extraction: Two authors independently screened studies and extracted relevant data, assessing risk of bias using the Cochrane risk-of-bias tool.
• Meta-Analysis: Meta-analysis was performed using Review Manager and Stata, with subgroup analyses based on constipation status, linaclotide dose, and PEG volume.

Key Findings:

• Lin + PEG improved total bowel cleansing quality (MD = 0.93, 95% CI (0.66–1.20), p < 0.00001).
• Lin + PEG reduced risks of vomiting (RR = 0.60, 95% CI (0.41–0.86), p = 0.006), abdominal pain (RR = 0.57, 95% CI (0.34–0.94), p = 0.03), abdominal distension (RR = 0.61, 95% CI (0.38–0.98), p = 0.04), and nausea (RR = 0.59, 95% CI (0.38–0.92), p = 0.02).
• No significant difference in total adverse events (RR = 0.76, 95% CI (0.57–1.01), p = 0.06).
• Lin + PEG reduced total procedure time (MD = -2.35 min, 95% CI (-3.11 to -1.60), p < 0.00001).
• The polyp detection rate was higher in the Lin + PEG group (RR = 1.25, 95% CI (1.01–1.55), p = 0.04).

Interpretation:

In elderly Chinese adults, Lin + PEG may enhance bowel cleansing and reduce procedure time, although the certainty of the safety evidence remains limited.

Limitations:

• The certainty of the safety evidence is limited.
• Heterogeneity in PEG volume, linaclotide dosage, and participant characteristics may affect the generalizability of the findings.

Conclusion:

Lin + PEG may improve bowel cleansing and reduce procedure time in elderly Chinese adults.

Sources:

• Systematic Review Registration