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Effect of hyoscine N-butylbromide on adenoma detection rate: meta-analysis of randomized clinical trials
Mohammad F Madhoun1, Tauseef Ali, William M Tierney
1Division of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma City, USA; Veteran Affairs Medical Center, Oklahoma City, USA.
Background And Aim:
Anti-spasmodic drugs may facilitate mucosal inspection during colonoscopy. The impact of hyoscine N-butylbromide (HBB) on polyp detection rate (PDR) and adenoma detection rate (ADR) is unclear.
Methods:
We conducted a reproducible literature search of multiple databases. Two reviewers independently compared manuscripts for PDR, ADR, advanced adenoma detection rate (AADR), and rates of complications. Pooling was conducted by fixed-effects and random-effects models. Relative risk (RR) estimates were calculated (95% confidence interval). I(2) index assessed heterogeneity.
Results:
Patient demographics were comparable. The pooled analysis showed a trend toward improving PDR and ADR among the HBB group compared with the placebo group but failed to reach statistical significance, (46% vs 43%, RR = 1.08 [0.94, 1.25], P = 0.27), (31% vs 28%, RR = 1.12 [0.97, 1.29], P = 0.11) respectively.
Conclusion:
HBB during colonoscopy may provide marginal improvements in ADR and PDR. However, heterogeneity in the available data precludes firm conclusions at this time.
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