Preliminary study of efficacy of doxazosin as a medical expulsive therapy of
distal ureteric stones in a randomized clinical trial.
Author(s): Zehri AA, Ather MH, Abbas F, Biyabani SR.
Affiliation(s): Section of Urology, Department of Surgery, Aga Khan University, Karachi,
Pakistan.
Publication date & source: 2010, Urology. , 75(6):1285-8
OBJECTIVES: To assess the clinical efficacy of doxazosin as the medical-expulsive
therapy for distal ureterolithiasis.
METHODS: A total of 65 patients with a symptomatic 4-7 mm distal ureteral stone
were included in the study. Patients were randomized to 1 of the 2 treatment
groups. Group 1 (n=32 patients) was the control group and received diclofenac
sodium 50 mg for their pain and group 2 (n=33 patients) received doxazosin (2 mg
daily at the night) along with diclofenac sodium 50 mg. The treatment duration
was until stone expulsion or 28 days, whichever come first. The primary endpoint
of the study was the stone expulsion rate. The secondary endpoints included time
to stone expulsion, use of analgesics, and number of emergency room visits,
hospitalizations, and drug side effects. Statistical analyses were performed
using chi-square test and Fisher exact test.
RESULTS: Both groups were comparable in terms of demographic, clinical, and
stone-related parameters. Stone expulsion rate was significantly higher in the
treatment group (38% for group 1 and 70% for group 2, P=.009) while the expulsion
time was significantly lesser in group 2 patients (P=.005). During the treatment
period, we observed significant differences between the 2 groups in the number of
pain episodes and analgesic used (P=.0001). None of the patients in either groups
reported adverse drug-related events.
CONCLUSIONS: Doxazosin significantly improves stone expulsion and is associated
with decreased colic frequency and use of analgesia. It is also well tolerated
with no adverse drug-related events.
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