Efficacy of silodosin or mirabegron in medical expulsive therapy for ureteral stones: a prospective, randomized-controlled study

Bayar, Göksel; Yavuz, Abdülmecit; Çakmak, Sedat; Ofluoğlu, Yılmaz; Kılınç, Muhammet Fatih; Küçük, Emrah; Aydın, Mustafa

doi:10.1007/s11255-019-02368-y

Cited by 19 publications

(29 citation statements)

References 20 publications

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“…Following a screening of the available databases, 405 potentially relevant publications were identified. Ultimately, 4 clinical trials [ 12 – 15 ] were selected for the study, including 197 cases of mirabegron and 201 cases of control, to assess the effectiveness of mirabegron in medical expulsive therapy for ureteral stones. A flow diagram detailing the literature selection process is shown in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

The Efficacy of Mirabegron in Medical Expulsive Therapy for Ureteral Stones: A Systematic Review and Meta-Analysis

Cai

Wei

et al. 2022

International Journal of Clinical Practice

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Background. This study aimed to assess the efficacy of mirabegron (50 mg daily) as a medical expulsive therapy for ureteral stones in adults. Materials and Methods. We searched PubMed, Embase, Cochrane Library, and Web of Science from inception to July 2021 to collect the clinical trials. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies by using the Cochrane risk of bias tool. Review Manager 5.3 software was used for the meta-analysis. Results. A total of four studies were included, involving 398 patients: 197 patients in mirabegron group and 201 patients in control group. The meta-analysis showed that the stone expulsion rate was higher in the mirabegron group than in the control group (OR: 2.12; 95% CI: 1.33 to 3.40; p = 0.002 ). Subgroup analysis identified that the stone expulsion rate of patients with stone size <5/6 mm was significantly higher than that of patients with stone size ≥5/6 mm (OR: 0.31; 95% CI: 0.13 to 0.72; p = 0.006 ). But no significant difference was identified between the mirabegron group and the control group for the stone expulsion interval (MD: −1.16, 95% CI: −3.56 to 1.24; p = 0.35 ). In terms of pain episodes, the mirabegron group was significantly lower than that of the control group (MD: −0.34, 95% CI: −0.50 to 0.19; p < 0.0001 ). Conclusions. The medical expulsive therapy with mirabegron had a significant effect in improving the stone expulsion rate for patients with ureteral stones, especially in those whose stone size <5/6 mm. Mirabegron had no effect on the stone expulsion interval but did decrease the pain episodes.

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Section: Resultsmentioning

confidence: 99%

The Efficacy of Mirabegron in Medical Expulsive Therapy for Ureteral Stones: A Systematic Review and Meta-Analysis

Cai

Wei

et al. 2022

International Journal of Clinical Practice

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“…The adverse events of mirabegron included mouth dryness, constipation, tachycardia, and urine retention, but the incidence of which was similar to that of the placebo [24,25]. In our included studies, Bayar reported that one patient experienced an episode of hypertension in the mirabegron group [11]. The remaining studies did not report any adverse events.…”

Section: Discussionmentioning

confidence: 79%

“…The search strategy identi ed 456 articles and 6 trials [10][11][12][13][14][15] (including 5 RCTs) with 462 patients were included in the nal analysis. The literature screening process is shown in Fig.…”

Section: Study Selection and Risk Of Biasmentioning

confidence: 99%

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Efficacy of Mirabegron in Medical Expulsive Therapy for Ureteral Stones: A Systematic Review and Updated Meta-analysis

Liu

Zhu

Huang

2022

Preprint

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The possibility of using mirabegron as a new medical expulsive therapy agent for ureteral stones has been studied owing to its relaxant effects on the ureteral smooth muscle. The objective of this study was to update the evidence regarding the efficacy of mirabegron in medical expulsive therapy for the management of ureteral calculi. We systematically searched PubMed, Cochrane library and Embase to collect the clinical trials from inception dates to August 2022. Meta-analysis and forest-plot figures were calculated with the software review manager v5.0. Six studies with 462 patients were eligible for inclusion. Mirabegron achieved significantly higher expulsion rate than control (pooled RR: 1.44, 95% CI: 1.12, 1.86; P = 0.004). A subgroup analyses showed that mirabegron has a significantly higher expulsion rate on stone sizes smaller than 5/6 mm (RR 1.4; 95% CI: 1.11–1.77; P = 0.005). The superior effect was not observed on stone sizes > 5/6 mm (RR 1.04; 95% CI: 0.80–1.35; P = 0.77). The pooled data showed no significant difference in the expulsion time between mirabegron and control group (MD: -0.53, 95% CI -5.77–4.71; P = 0.84). There was no significant difference between the mirabegron group and the control group in the episodes of renal colic (MD -0.18; 95% CI -0.39–0.02; P = 0.08). But patients receiving mirabegron had less analgesic consumption. No serious adverse events were reported with mirabegron treatment. This systematic review shows that mirabegron is an effective and safe medical expulsive therapy agent in patients with ureteral stones.

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“…42 Regarding all these studies one can derive that management of distal ureteric stones with shock wave lithotripsy and ureteroscopy is expensive and comprimises certain risks such as postoperative stricture, perforation and ureteric avulsion. 42 In a prospective randomized controlled trial by Bayar et al (2020) silodosin has been compared with mirabegron in aspect of expulsive therapy for ureteral stones. This study suggested that: the interval of stone expulsion in patients with distal localisation and the interval of stone expulsion in patients with stone size smaller than 6 mm were shorter in the silodosin group than the control group.…”

Section: Silodosin and Stone Expulsion Via Surgical Interventionmentioning

confidence: 99%

The efficacy and safety of silodosin-a review of literature

Faikoglu¹,

Saygisever-Faikoglu²,

Ozcan³

et al. 2021

PPIJ

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Background: Benign prostatic hyperplasia is a compilation of irritative voiding and obstructive symptoms which are consistent with reduced emptying of urine from and defective storage of urine in the bladder. Medications are a common method of treatment to delay complications and reduce symptoms. Silodosin is a highly selective alpha-1A adrenoceptor blocker that has 162 times more affinity for alpha-1a than alpha 1b, thus resulting in high uroselectivity and decreased side effects. Aim:In this review article our aim was to elucidate the clinical effects, safety and tolerability profile of silodosin in the treatment of benign prostatic hyperplasia.Method: Literatures were retrieved by a PubMed search, using different combinations of pertinent keywords (e.g., silodosin, hypotension, benign prostatic hyperplasia), without any limitations in terms of publication date and language. Papers which assessed the therapeutic efficacy and tolerability of silodosin were selected for inclusion according to their relevance for the topic, as judged by the authors. Overvıew of clinical data:Silodosin is indicated for the treatment of the signs and symptoms of benign prostatic hyperplasia. It has a rapid onset of effect in men with lower urinary tract symptoms and improvements were seen in voiding and storage symptoms, maximum urinary flow rate and health-related quality of life. The efficacy of silodosin was maintained in several controlled studies and also non-interventional real-world setting. Silodosin was generally well tolerated. Conclusion:Silodosin is the most uroselective α-blocker. Silodosin has been emphasized in the 2021 European Association of Urology Conservative treatment of non-neurogenic male LUTS guidelines and it has been reported that the hypotensive effect of silodosin is comparable with placebo and has favorable safety and tolerability profile. Dosing of silodosin does not need to be adjusted according to age, concurrent medication with antihypertensives and phosphodiesterase type 5 inhibitors.

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Efficacy of silodosin or mirabegron in medical expulsive therapy for ureteral stones: a prospective, randomized-controlled study

Cited by 19 publications

References 20 publications

The Efficacy of Mirabegron in Medical Expulsive Therapy for Ureteral Stones: A Systematic Review and Meta-Analysis

The Efficacy of Mirabegron in Medical Expulsive Therapy for Ureteral Stones: A Systematic Review and Meta-Analysis

Efficacy of Mirabegron in Medical Expulsive Therapy for Ureteral Stones: A Systematic Review and Updated Meta-analysis

The efficacy and safety of silodosin-a review of literature

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