📃 Paper Title: Medical expulsive therapy in adults with ureteric colic: a multicentre, randomised, placebo-controlled trial (SUSPEND trial)
🧍 Author: Pickard
🕒 Year: 2015
📚 Journal: The lancet
🌎 Country: U.K.
ㅤContext to the study:
What is a paper that gives evidence to omit the routine use of a-blockers for ureteric stones?
ㅤ✅ Take-home message of study:
The article concludes that neither tamsulosin nor nifedipine showed any clinically useful benefit for increasing stone passage, and the past studies that showed a positive benefit may be limited due to small sample sizes, differences in inclusion criteria, and inadequate masking of participants and assessors.
The findings of the SUSPEND trial provide strong evidence that these drugs are unlikely to be useful in routine clinical care of people with ureteric colic.
The trial provides some of the highest quality evidence about clinical effectiveness of MET
ㅤ RCT - 24 UK centers
ㅤ
Study participants:
1,167 participants across 3 arms (Randomized to tamsulosin 400mcg vs. nifedipine 30mg, or placebo)
ㅤ
ㅤ
Key study outcomes:
Follow-up period = 4 weeks
Primary outcome was the proportion of participants who did not need further intervention for stone clearance within 4 weeks:
80% in placebo group
81% in tamsulosin
80% in nifedipine
(No difference detected between groups)
Serious adverse events were reported in three participants in the nifedipine group and one participant in the placebo group.
ㅤ
ㅤ
Study Limitations:
The trial did not use imaging evidence of stone passage as a trial outcome
The researchers used crude categorization of size for sub-group analysis (<5mm vs. >5mm)
Did not use stone-specific patient reported outcomes
ㅤ