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Table 1 Summary of the included studies

From: Comparison of the effectiveness of polyethylene glycol with and without electrolytes in constipation: a systematic review and network meta-analysis

Study

Total (N)

Length of study

Constipation type

Baseline stool frequency (SD)

Concomitant laxative use

Age mean (SD) years

Gender (% male)

Polyethylene glycol formulation and daily dose

Polyethylene glycol (N)

Comparator and daily dose

Comparator (N)

Andorsky RI 1990 [12]

37

2 × 5 days

Chronic

87.5 % ≤ 2 stools/week

Continued use of fibre and bulk-forming agents. Laxatives or enemas for treatment failure: P = 12.5 %, C = 18.8 %

P1: 62

P1: 25 %

PEG3350 + E

High dose 16

Placebo

16

P2: 58

P2: 19 %

High dose 16 oz

Low dose 16

Low dose 8 oz

Attar A 1999 [13]

115

4 weeks

Chronic

Not specified

Suppositories, micro-enemas allowed. Any use: P = 16 %, C = 34 %

P: 55 (24)

P: 15 %

PEG3350 + E

60

Lactulose

55

C: 55 (22)

C: 22 %

13–39 g

10–30 g

Awad RA 2010 [14]

47

30 days

Irritable bowel syndrome (IBS-C)

P: 1.3 (0.6)

Not allowed. P: 1 use of glycerine suppository

P: 30.7 (8)

12 %

PEG3350

23

Placebo

24

C: 1.5 (0.7)

C: 1 use of enema

C: 36.5 (10)

 

10.35 g

Bouhnik Y 2004 [15]

65

28 days

Chronic, idiopathic

85 % < 3 stools/week

Suppositories, enemas allowed during washout, stopped 48 hours before baseline. 9 % of patients took concomitant treatment at study entry and all were stopped

57 (18)

14 %

PEG4000 10–30 g

32

Lactulose 10–30 g

33

Chapman RW 2013 [16]

139

28 days

Irritable bowel syndrome (IBS-C)

P: 1.28 (0.912)

Rescue medication bisacodyl if no bowel movement for 3 consecutive days. Mean No. weekly rescue doses: P = 0.30, C = 0.44

41.3 (14.8)

17 %

PEG3350 + E

68

Placebo

71

C: 1.37 (0.849)

13.8–41.4 g

Chaussade S 2003 [17]

266

2 weeks

Chronic, idiopathic

P(H): 2.0 (0.9)

Rescue medication suppository if no bowel movement for 3 consecutive days. Stools post-suppository use were not included in study results

52.2 (18.5)

15 %

PEG3350 + E

High dose 69

PEG4000 High dose 20 g

High dose 67

P(L): 2.2 (1.3)

High dose 11.8 g

Low dose 69

Low dose 10 g

Low dose 65

Low dose 5.9 g

C(H): 2.4 (1.7)

C(L): 1.8 (1.0)

Cinca R 2013 [18]

240

2 weeks

Chronic

P: 0.7 (0.8)

Rescue medication ducosate micro-enema if no bowel movement for 3 consecutive days. Use of micro-enema: P = 0.8 %, C = 3.4 %

P: 40.0 (14.5)

0 %

PEG335 0 + E

120

Prucalopride 1–2 mg (serotonin [5-HT4] agonist)

116

C: 0.7 (0.8)

C: 40.5 (13.2)

13.71–27.42 g

Cleveland MV 2001 [19]

23

2 × 2 weeks

History of constipation

2.6 (1.75)

Not allowed

47.7

4 %

PEG3350 10.35 g

23

Placebo

23

Corazziari E 1996 [20]

55

4 weeks

Chronic

P: 2.2 (0.5)

Rescue medication, laxatives if no bowel movement for 5 consecutive days. Use of laxatives: P = 16 %, C = 48 %

41.8 (14.8)

P: 32 %

PEG4000 + E 17.5 g

25

Placebo

23

C: 1.9 (0.8)

C: 13 %

Corazziari E 2000 [21]

70

20 weeks

Chronic

P: 1.53 (1.35)

Rescue medication, laxatives if no bowel movement for 5 consecutive days. Use of laxatives was less frequent in PEG + E than placebo (P < 0.001)

43 (15)

17 %

PEG4000 + E 35 g

33

Placebo

37

C: 1.29 (1.04)

Di Palma JA 1999 [22]

AM: 50 LT 35

10 days

Reported constipation

Not specified

Not allowed

AM: 36.2

AM: 6 %

PEG3350

AM high dose: 50

Placebo

AM: 50

LT: 75.7

LT: 46 %

AM high dose: 34 g

AM low dose: 50

LT: 17

AM low dose: 17 g

LT high dose: 17

LT high dose: 12 g

LT low dose: 17

LT low dose: 6 g

Di Palma JA 2000 [23]

151

14 days

History of constipation

Not specified

Not allowed

45.2

13 %

PEG3350 17 g

80

Placebo

71

Di Palma JA 2007A [24]

100

4 Weeks

Secondary to medications

Not specified

Fibre or other laxatives not allowed

58

26 %

PEG3350 17 g

46

Placebo

46

Di Palma JA 2007B [25]

304

6 months

Chronic

P: 86.5 % < 3 stools/week

Fibre not allowed. Rescue medication bisacodyl if no bowel movement for 4 consecutive days. Mean use of bisacodyl 5 mg: P = 2.8, C = 3.9 tablets/week

53

15 %

PEG3350 17 g

202

Placebo

100

C: 94.4 % < 3 stools/week

Di Palma JA 2007C [26]

237

28 days

Chronic

100 % < 3 stools/week

Fibre not allowed. Rescue medication bisacodyl if no bowel movement for 4 consecutive days. Mean use of bisacodyl 5 mg: P = 1.4, C = 1.0 tablets/week

46

10 %

PEG3350 17 g

118

Tegaserod 12 mg (serotonin [5-HT4] agonist)

116

Freedman MD 1997 [27]

57

3 × 2 weeks

Opioid-induced

Not specified

Additional milk of magnesia or bisacodyl allowed. No difference in use between PEG + E and lactulose

Range 18–50

Not specified

PEG3350 + E 14 g

57

Placebo Lactulose 30 mL

Placebo 57

Lactulose 57

Klauser AG 1995 [28]

8

2 × 6 weeks

Chronic

Median 3

Sodium picosulfate was allowed except for the last week of each study period. Median drops per day: P = 0, C = 4

46 (4)

0 %

PEG4000 60 g

8

Placebo

8

Seinela L 2009 [29]

65

4 weeks

Chronic functional

P: 9.3

Continued use of Plantago ovata seeds was allowed. Rescue medication bisacodyl 10 mg suppository if no bowel movement for 3 consecutive days. Use of suppositories: PEG + E = 12.5 %

86

34 %

PEG4000 + E 6–24 g

32

PEG4000 6–24 g

30

C: 8.4

PEG = 3.3 %

Wang H 2005 [30]

126

2 weeks

Chronic functional

P: 1.18 (0.77)

Not allowed

P: 51. 2 (14.8)

40 %

PEG3350 + E 27.6 g

63

Isphagula husk 7 g (bulk forming)

63

C: 1.33 (0.68)

C: 50.0 (17.1)

Zangaglia R 2007 [31]

57

8 weeks

History of constipation amongst Parkinson’s Disease

P: 1.9 (0.56)

Rescue medication, rectal laxatives. Use of rectal laxatives: P = 4.3 % week 4 & 0 % week 8

71.0 (6.5)

60 %

PEG4000 + E 7.3–21.9 g

29

Placebo

28

C: 2.0 (0.6)

C = 9.5 % week 4 & 12.5 % week 8

  1. P Polyethylene glycol group, C Comparator group, AM Ambulatory healthy outpatients, LT Long term, H High dose, L Low dose