Drug Combo Improves Stone Passage

A higher rate was observed with a dual regimen of tamsulosin and prednisone.
A higher rate was observed with a dual regimen of tamsulosin and prednisone.

ORLANDO—Tamsulosin plus prednisone works better than either drug alone in clearing distal ureteral stones, investigators reported at the American Urological Association 2014 annual meeting.

In a prospective, non-randomized study, Maurizio Brausi, MD, of B. Ramazzini Hospital in Carpi, Italy, enrolled 120 patients with renal colic who presented to the emergency departments of 2 urology centers. Doctors diagnosed distal ureteral stones radiologically.

The researchers assigned patients to 1 of 3 groups: group A included 40 patients treated with tamsulosin 0.4 mg per day alone; group B, which included 35 patients treated with prednisone 25 mg per day for 5 days, 10 mg per day for 5 days, and 5 mg per day for 5 days; and group C, which included 45 patients treated with tamsulosin 0.4 mg per day and prednisone (following the same schedule as group B). Groups A, B, and C had a mean stone diameter of 7.3, 4.2, and 7.0 mm, respectively. During the study, 3 patients in group A and 3 in group B were lost to follow-up.

Dr. Brausi's group observed spontaneous passage of stones in 67.5% of group A, 34.2% of group B, and 92.8% of group C. Endourological procedures were required for 33.5% of group A, 65% of group B, and 7.8% of group C.

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