Effect of hyoscine N-butylbromide on adenoma detection rate: meta-analysis of randomized clinical trials

Dig Endosc. 2015 Mar;27(3):354-60. doi: 10.1111/den.12340. Epub 2014 Oct 16.

Abstract

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.

Keywords: adenoma detection rate; antispasmodic; colonoscopy; hyoscine N-butylbromide; polyp detection rate.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review

MeSH terms

  • Adenoma / diagnosis*
  • Adenoma / epidemiology
  • Butylscopolammonium Bromide*
  • Colonic Neoplasms / diagnosis*
  • Colonic Neoplasms / epidemiology
  • Colonic Polyps / diagnosis*
  • Colonic Polyps / epidemiology
  • Colonoscopy / methods*
  • Female
  • Humans
  • Image Enhancement / methods*
  • Incidence
  • Male
  • Randomized Controlled Trials as Topic
  • Reproducibility of Results
  • Sensitivity and Specificity

Substances

  • Butylscopolammonium Bromide