Medical expulsive therapy in adults with ureteric colic: a multicentre, randomised, placebo-controlled trial

Pickard, Robert; Starr, Kathryn; MacLennan, Graeme; Lam, Thomas Boon Leong; Thomas, Ruth; Burr, Jennifer; McPherson, Gladys; McDonald, Alison; Anson, Ken; N’Dow, James; Burgess, Neil; Clark, Terry; Kilonzo, Mary; Gillies, Katie; Shearer, Kirsty; Boachie, Charles; Cameron, Sarah; Norrie, John; McClinton, Samuel

doi:10.1016/s0140-6736(15)60933-3

Cited by 310 publications

(264 citation statements)

References 24 publications

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“…In most studies, however, methodologic quality was limited. A recent randomized trial challenges the clinical effect of MET: subjects with a stone ,10 mm were randomized to placebo, tamsulosin, or nifedipine to facilitate stone passage, with a primary outcome of additional intervention on the basis of self-report (69). In this trial, there were no differences between placebo and either a-blocker or calcium channel blocker; however, the study may have been underpowered to detect a difference among patients with distal ureteral stones.…”

Section: Medical Expulsive Therapymentioning

confidence: 99%

Urinary Stone Disease: Advancing Knowledge, Patient Care, and Population Health

Scales

Tasian

Schwaderer

et al. 2016

CJASN

137

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Expanding epidemiologic and physiologic data suggest that urinary stone disease is best conceptualized as a chronic metabolic condition punctuated by symptomatic, preventable stone events. These acute events herald substantial future chronic morbidity, including decreased bone mineral density, cardiovascular disease, and CKD. Urinary stone disease imposes a large and growing public health burden. In the United States, 1 in 11 individuals will experience a urinary stone in their lifetime. Given this high incidence and prevalence, urinary stone disease is one of the most expensive urologic conditions, with health care charges exceeding $10 billion annually. Patient care focuses on management of symptomatic stones rather than prevention; after three decades of innovation, procedural interventions are almost exclusively minimally invasive or noninvasive, and mortality is rare. Despite these advances, the prevalence of stone disease has nearly doubled over the past 15 years, likely secondary to dietary and health trends. The NIDDK recently convened a symposium to assess knowledge and treatment gaps to inform future urinary stone disease research. Reducing the public health burden of urinary stone disease will require key advances in understanding environmental, genetic, and other individual disease determinants; improving secondary prevention; and optimal population health strategies in an increasingly cost-conscious care environment.

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Section: Medical Expulsive Therapymentioning

confidence: 99%

Urinary Stone Disease: Advancing Knowledge, Patient Care, and Population Health

Scales

Tasian

Schwaderer

et al. 2016

CJASN

137

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“…6 Overall, they demonstrated no significant difference between MET and placebo for the primary outcome of stone passage at four weeks. It is important to note that lack of urologic intervention is an imprecise surrogate marker for evaluating the true efficacy of MET for stone passage, but does have significant value as a patient-oriented outcome.…”

Section: Commentarymentioning

confidence: 91%

Comparison of Tamsulosin, Nifedipine, and Placebo for Ureteric Colic

Gottlieb

Nakitende

2015

CJEM

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“…In the recent SUSPEND trial it was to be no more effective than placebo 109 . Nifedipine reduces contractility of the distal ureter similarly to alphaadrenergic blockers allowing improved stone passage 120 .…”

Section: Calcium-channel Blockersmentioning

confidence: 99%

“…It also reduced both the requirement for analgesia and mean stone passage time. However, in 2015 a large randomized trial of 1167 patients (SUSPEND trial) assessing the efficacy of alpha blockers (and calcium channel blockers) vs. placebo failed to demonstrate a significant benefit in stone passage 109 .…”

Section: Alpha-blockersmentioning

confidence: 99%