scholarly journals Systematic Review of Efficacy and Safety of Silodosin in Medical Expulsive Therapy for the Management of Ureteral Stones – Based on Indian Evidences

2021 ◽  
Vol 14 (02) ◽  
pp. 733-738
Author(s):  
Balakrishnan Sadasivam ◽  
Santenna Chenchula ◽  
Avik Ray
Keyword(s):  
Indian Population ◽  
Cochrane Library ◽  
Ureteral Stones ◽  
Efficacy And Safety ◽  
Medical Subject Headings ◽  
Expulsion Rate ◽  
Medical Expulsive Therapy ◽  
Adrenoceptor Antagonist ◽  
Treatment Measures ◽  
Randomised Controlled

Introduction: Urolithiasis is quite a common disorder affecting around two million people in India every year. Minimally invasive therapies are effective treatment measures in most of the cases. However, a watchful waiting approach with pharmacotherapy promotes the expulsion of stones in a shorter time. We hereby review the efficacy and safety of silodosin, a selective α-1A adrenoceptor antagonist, in medical expulsive therapy for the management of urolithiasis based on the evidences in Indian population. Methods: Medical Subject Headings (MeSH) keywords which were used to systematically search electronic databases: PubMed/Medline, Cochrane Library and Google Scholar from their inception to February 2020 were “Silodosin”, “Ureteral calculi”, “Medical expulsive therapy”, “India”, “randomised controlled trials” and “prospective observational studies”. A total of 29 relevant studies could be found and were included in our analysis. Results: The primary outcomes considered were the stone expulsion rate (SER) and stone expulsion time (SET) along with pain episodes and safety outcomes like orthostatic hypotension and retrograde ejaculation. Eight studies with a total of 1064 patients were identified as evidences considering Indian population which compared silodosin with controls like tamsulosin or tadalafil. Conclusions: Silodosin is highly effective in Indian population for increasing stone expulsion for those with ureteral stones (distal ureteral stones with diameter ≥5 mm and ≤10 mm) with shorter expulsion times along with fewer episodes of pain. It is also effective in post-lithotripsy for accentuating clearance rate and curtailing time to passage of the stones.

scholarly journals Efficacy and safety of omalizumab in chronic rhinosinusitis with nasal polyps: a systematic review and meta-analysis of randomised controlled trials

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047344
Author(s):  
Qingwu Wu ◽  
Lianxiong Yuan ◽  
Huijun Qiu ◽  
Xinyue Wang ◽  
Xuekun Huang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Chronic Rhinosinusitis ◽  
Randomised Controlled Trials ◽  
Nasal Polyps ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomised Controlled

ObjectivesTo assess the efficacy and safety of omalizumab for chronic rhinosinusitis with nasal polyps (CRSwNP) and to identify evidence gaps that will guide future research on omalizumab for CRSwNP.DesignSystematic review and meta-analysis.Data sourcesA comprehensive search was performed in PubMed, Embase, Web of Science and the Cochrane Library on 13 October 2020.Eligibility criteriaRandomised controlled trials (RCTs) comparing omalizumab with placebo, given for at least 16 weeks in adult patients with CRSwNP.Data extraction and synthesisTwo independent authors screened search results, extracted data and assessed studies using the Cochrane risk of bias tool. Data were pooled using the inverse-variance method and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed by the χ2 test and the I2 statistic.ResultsA total of four RCTs involving 303 participants were identified. When comparing omalizumab to placebo, there was a significant difference in Nasal Polyps Score (MD=−1.20; 95% CI −1.48 to −0.92), Nasal Congestion Score (MD=−0.67; 95% CI −0.86 to −0.48), Sino-Nasal Outcome Test-22 (MD=−15.62; 95% CI −19.79 to −11.45), Total Nasal Symptom Score (MD=−1.84; 95% CI −2.43 to −1.25) and reduced need for surgery (risk ratio (RR)=5.61; 95% CI 1.99 to 15.81). Furthermore, there was no difference in the risk of serious adverse events ((RR=1.40; 95% CI 0.29 to 6.80), adverse events (RR=0.83; 95% CI 0.60 to 1.15) and rescue systemic corticosteroid (RR=0.52; 95% CI 0.17 to 1.61).ConclusionsThis was the first meta-analysis that identified omalizumab significantly improved endoscopic, clinical and patient-reported outcomes in adults with moderate to severe CRSwNP and it was safe and well tolerated.PROSPERO registration numberCRD42020207639.

scholarly journals Efficacy and Safety of Alfuzosin as Medical Expulsive Therapy for Ureteral Stones: A Systematic Review and Meta-Analysis

PLoS ONE ◽  
2015 ◽  
Vol 10 (8) ◽  
pp. e0134589 ◽  
Author(s):  
Chenli Liu ◽  
Guohua Zeng ◽  
Ran Kang ◽  
Wenqi Wu ◽  
Jiasheng Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Ureteral Stones ◽  
Efficacy And Safety ◽  
Medical Expulsive Therapy

E73 Efficacy of a selective alpha 1A adrenoceptor antagonist as a medical expulsive therapy against ureteral stones

2011 ◽  
Vol 10 (7) ◽  
pp. 478
Author(s):  
Y. Itoh ◽  
A. Okada ◽  
T. Yasui ◽  
K. Taguchi ◽  
K. Niimi ◽  
...  
Keyword(s):  
Ureteral Stones ◽  
Medical Expulsive Therapy ◽  
Adrenoceptor Antagonist

scholarly journals A comparison of tamsulosin and silodosin versus tadalafil in medical expulsive therapy for distal ureteral stone in men: a prospective study

2021 ◽  
Author(s):  
Metin Gur ◽  
Suleyman Tumer Caliskan ◽  
Muhammet Bahaettin Ulu ◽  
Ekrem Akdeniz ◽  
Kemal Ozturk
Keyword(s):  
Clinical Findings ◽  
Ureteral Stones ◽  
Control Group ◽  
Adult Males ◽  
Expulsion Rate ◽  
Medical Expulsive Therapy ◽  
Study Results ◽  
Significant Difference ◽  
Distal Ureteral Stone ◽  
Group 2

Objectives: To evaluate the efficacy of tamsulosin, silodosin, and tadalafil as medical expulsive therapy for distal ureteral stones in men. Methods: Adult males meeting the inclusion criteria were randomized into one of four treatment arms - dexketoprofen (control group), tamsulosin (Group 1), silodosin (Group 2), and tadalafil (Group 3). The stone expulsion rate after four weeks represented the primary endpoint, while the stone expulsion rate at the end of the study and the incidence of adverse events constituted secondary endpoints. Clinical findings were compared between all four drug groups. Results: No statistically significant difference was observed among the groups in terms of age, body mass index, stone futures, expulsion time, pain episodes, or total analgesic use. Expulsion rates in the fourth week were 42.5%, 80%, 82.5%, and 75%, respectively. The stone expulsion rates in groups 1, 2, and 3 were significantly higher than in the control group (p < 0.001). However, the differences between groups 1, 2, and 3 were not statistically significant. No serious adverse effects were observed during the study period. Conclusion: The study results showed a higher expulsion rate in male patients using tamsulosin, silodosin and tadalafil for distal ureteral stones, but no significant superiority between these. All three are safe, effective, and well-tolerated, causing minimal side-effects.

scholarly journals Mirabegron Role in Urolithiasis Management: What you should Know

2020 ◽  
Author(s):  
Eduar S. Rodríguez ◽  
David Naranjo
Keyword(s):  
Pain Control ◽  
Controlled Trial ◽  
Ureteral Stones ◽  
Clinical Scenario ◽  
Expulsion Rate ◽  
Ureteral Catheter ◽  
Medical Expulsive Therapy ◽  
Randomized Controlled ◽  
Double J Stent ◽  
Double Blinded

AbstractThe purpose of the present study was to develop a narrative review of the available evidence of mirabegron efficacy in three scenarios: as a medical expulsive therapy; as a medical treatment to increase a successful access to stones before ureteroscopy, and management of double-J stent-related symptoms. Only two original studies have evaluated its use as a medical expulsive therapy, with contradictory results in terms of stone expulsion rate; however, both demonstrated a better pain control in the mirabegron group. One randomized controlled trial (RCT) found a higher successful access to ureteral stones when mirabegron was administered 1 week before the ureteroscopy. And two RCTs demonstrated its efficacy in diminishing discomfort related with double-J stent. There is a promising role for the use of mirabegron in the arsenal of urolithiasis treatment, even as a medical expulsive therapy, before ureteroscopy surgery, to increase the successful access to the stones and after the placement of ureteral catheter to reduce the related symptoms. However, larger-scaled prospective double-blinded RCTs are needed before it can be used with these purposes in the clinical scenario.

Efficacy of selective α1A adrenoceptor antagonist silodosin in the medical expulsive therapy for ureteral stones

2011 ◽  
pp. no-no ◽  
Author(s):  
Yasunori Itoh ◽  
Atsushi Okada ◽  
Takahiro Yasui ◽  
Shuzo Hamamoto ◽  
Masahito Hirose ◽  
...  
Keyword(s):  
Ureteral Stones ◽  
Medical Expulsive Therapy ◽  
Adrenoceptor Antagonist
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