Does hyoscine butylbromide really improve polyp detection during colonoscopy? A meta-analysis of randomized controlled trials

AIM:To investigate the benefits of hyoscine butylbromide in polyp detection during colonoscopy by a meta-analysis of available randomized controlled trials(RCTs).METHODS:Databases,including PubMed,EMBASE,the Cochrane Library,and the Science Citation Index up to September 2013,were searched.The primary outcome was polyp detection rate,and the secondary outcome was adenoma detection rate.The metaanalysis was performed using the free software Review Manager.Differences observed between the treated and the control groups were expressed as odds ratio(OR)with a 95%confidence interval(CI).A fixedeffects model was used to pool data when statistical heterogeneity was absent.If statistical heterogeneity was present(P<0.05),a random-effects model was used.RESULTS:The initial search identified nine articles.After screening,five RCTs with a total of 1998 patients were included in this meta-analysis.Of the five studies,all described a comparison of baseline patient characteristics and showed that there was no statistically significant difference between the two groups.Among the 1998 patients,1006 received hyoscine butylbromide and 992 were allocated to the control group,and the polyp detection rate was reported.There were no significant differences between the treated and the control group(OR=1.09,95%CI:0.91-1.31,P=0.33).Four RCTs included 1882 patients,of whom948 received hyoscine butylbromide,and the adenoma detection rate was reported.There were no significant differences between the treated and the control group(OR=1.13,95%CI:0.92-1.38,P=0.24).CONCLUSION:The use of hyoscine butylbromide did not significantly improve the polyp detection rate during colonoscopy.

Evaluation of the Influence of Hyoscine Butylbromide on the Oral Bioavailability of Lansoprazole in Healthy Adult Volunteers

The gastroesophageal reflux and/or peptic ulcer diseases are clinical conditions that occur usually accompanied of symptomatic pain. Lansoprazole, a proton pump inhibitor class drug is widely used in clinical practice for treatment of these diseases. However, its efficacy can be improved by combining with spasmolytic and/or visceral analgesic such as hyoscine butylbromide. Since hyoscine butylbromide is barely absorbed and exerts some local effects at gastrointestinal tract which may modify the absorption of lansoprazole, it is important to establish if there is a pharmacokinetic interaction after the oral concomitant administration of both drugs. For this objective, twenty-five subjects received under a crossover design an oral administration of lansoprazole (15 mg) plus placebo or a fixed-dose combination with hyoscine butiylbromide (15 mg + 10 mg, respectively). Plasma samples were obtained at different times during 10 hours. Lansoprazole plasma concentrations were determined by a high performance liquid chromatography method coupled to tandem mass spectrometry. Fixed-dose combination was well tolerated. Lansoprazole pharmacokinetic parameters were: Cmax 621.81 ± 212.79 and 450.38 ± 192.14 ng/mL;AUC0-t 1941.36 ± 845.57 and 1454.66 ± 757.28 ng·h/mL;tmax 2.83 ± 0.99 and 3.40 ± 1.82h;t1/2 1.35 ± 0.39 and 1.45 ± 0.51 h, for alone and combined fixed-dose formulation, respectively. Pharmacokinetic parameters were compared by analysis of variance and ratios of AUC0-t, Cmax and 90% confidence intervals obtained. Since confidence intervals exceed the 80% - 125% limits for these parameters, we conclude that there is a significantly pharmacokinetic interaction of lansoprazole when it is administered concomitantly with hyoscine butylbromide.

Determination of Hyoscine Butylbromide with Ag＋ and Dihalogenated Fluorescein Dyes in Capsules by Resonance Rayleigh Scattering Method Coupled with Flow Injection Analysis Techniquet

In pH 4.2-5.2 HOAc-NaOAc buffer solution, Ag＋ reacted with dihalogenated fluorescein （DHF） dyes to form a 1 ; 2 anionic complex. This anionic complex could further react with hyoscine butylbromide （HBB） to form 1 ： 1 ion-association complex, which resulted in the significant enhancement of resonance Rayleigh scattering （RRS） intensity. Therefore, a novel method for the determination of HBB by resonance Rayleigh scattering （RRS） coupled with flow injection analysis （FIA） technique has been established. The present method had been applied to determine HBB in capsules and the results were in good agreement with those obtained by the literature method.