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The safety and efficacy of doxazosin in medical expulsion therapy for distal ureteric calculi: A meta-analysis
- Source :
- PLoS ONE, Vol 16, Iss 1, p e0245741 (2021), PLoS ONE
- Publication Year :
- 2021
- Publisher :
- Public Library of Science (PLoS), 2021.
-
Abstract
- Purpose Alpha-adrenergic receptor blockers can be effectively used in the context of medical expulsion therapy (MET) to treat ureteric stones. This study was designed to evaluate the safety and efficacy of doxazosin in MET relative to placebo or tamsulosin. Methods We systematically searched the PubMed, the Cochrane Library, EMBASE, Chinese Academic Database, and Web of Science databases to select randomized controlled trials (RCT) that compared the use of doxazosin with placebo or tamsulosin to treat ureteric stones. All patients we included were limited to those diagnosed with visible stones in the distal ureter. The diameter of ureteric stones does not exceed 10 mm. Results Eight trials comparing doxazosin with placebo or tamsulosin containing 667 patients were assessed in the final analysis. The meta-analysis showed that doxazosin effectively treated ureteric stones and was better than placebo in terms of efficacy. Relative to the placebo group, the expulsion rate of stones from the distal ureter (OR = 3.00, 95% CI [2.15, 4.19], I2 = 0%, P < 0.00001) was significantly increased, and the expulsion time (days) was shortened (mean difference) (MD) = −4.03, 95% CI [−4.53, −3.53], P < 0.00001). The doxazosin group experienced fewer pain episodes (MD = −0.78, CI = [−0.94, −0.23], I2 = 0%, P < 0.00001) than the placebo group. A subgroup analysis showed that the doxazosin group had a higher expulsion rate (of 5–10 mm stones) compared with the placebo group. Although doxazosin resulted in significantly more adverse effects compared with the placebo, the patient’s symptoms were mild and no further medical interventions were required. Moreover, the expulsion time (days) was shorter for patients receiving doxazosin (MD = −0.61, 95% CI [−0.97, −0.24], I2 = 39%, P = 0.001) than those receiving tamsulosin. Conclusion Compared with the placebo group, patients receiving doxazosin had a greater expulsion rate, a reduced expulsion time, and fewer pain episodes. The expulsion time of doxazosin was shorter than that of tamsulosin.
- Subjects :
- 030232 urology & nephrology
urologic and male genital diseases
law.invention
Database and Informatics Methods
Mathematical and Statistical Techniques
0302 clinical medicine
Randomized controlled trial
law
Medicine and Health Sciences
Database Searching
Randomized Controlled Trials as Topic
Multidisciplinary
Pharmaceutics
Statistics
Metaanalysis
medicine.anatomical_structure
030220 oncology & carcinogenesis
Physical Sciences
Medicine
Anatomy
Safety
Research Article
medicine.drug
medicine.medical_specialty
Drug Research and Development
Ureteral Calculi
Urology
Science
Pain
Context (language use)
Subgroup analysis
Research and Analysis Methods
Placebo
03 medical and health sciences
Signs and Symptoms
Ureter
Drug Therapy
Adverse Reactions
Tamsulosin
medicine
Doxazosin
Humans
Clinical Trials
Statistical Methods
Adverse effect
Pharmacology
business.industry
Biology and Life Sciences
Alpha-Adrenergic Antagonist Therapy
Renal System
Randomized Controlled Trials
Clinical Medicine
business
Mathematics
Receptor Antagonist Therapy
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- PLOS ONE
- Accession number :
- edsair.doi.dedup.....c5f3142f139339637b1b7b60505a33dd