Review: medical therapy with calcium channel blockers or {alpha} blockers helps patients to pass urinary stones

doi:10.1136/ebm.12.1.15

Evidence-Based Medicine 2007;12:15; doi:10.1136/ebm.12.1.15

Therapeutics

Review: medical therapy with calcium channel blockers or ${alpha}$ blockers helps patients to pass urinary stones

Hollingsworth JM, Rogers MA, Kaufman SR, et al. Medical therapy to facilitate urinary stone passage: a meta-analysis. Lancet 2006;368:1171–9.[CrossRef][Medline]

Q In patients with urolithiasis, are calcium channel blockers or ${alpha}$ blockers more effective than standard therapy for helping patients pass urinary stones?

Clinical impact ratings GP/FP/Primary care $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Internal medicine $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Emergency care $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Surgery—urology $*$ $*$ $*$ $*$ $*$ ${star}$ ${star}$

Key Words: adrenergic alpha antagonists • calcium channel blockers • urinary calculi

The first 150 words of the full text of this article appear below.

METHODS

Data sources: Medline, PREMEDLINE, CINAHL, EMBASE/Excerpta Medica, abstractsfrom annual meetings, study authors, and drug manufacturers.

Study selection and assessment: randomised controlled trials (RCTs) that evaluated calcium channelblockers or ${alpha}$ blockers as the main treatment for ureteral stonedisease (mean size 3.9–7.8 mm) and had $>=$ 1 week follow up(range 15–48 d). Studies were excluded if medical therapywas an adjunct to surgery. 9 RCTs (n = 693, mean age range 34–47y, 25% to 60% women) met the selection criteria. In 3 RCTs,corticosteroids were given to the treatment groups with thecalcium channel blocker nifedipine. Non-steroidal anti-inflammatorydrugs were given to both treatment and control groups in 7 RCTs.RCTs were pooled using a fixed effects model. Quality assessmentof the studies included method of randomisation, concealmentof allocation, blinding, loss to follow up, and intention totreat analysis.

Outcomes: proportion of patients who passed stones.

MAIN RESULTS

More patients . . . [Full text of this article]

Gary C Curhan, MD, ScD

Brigham and Women’s Hospital,
Boston, Massachusetts, USA

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