Sammenligning af Mirabegron og Tamsulosin til udstødning af urinledersten
En randomiseret kontrolleret undersøgelse, der sammenligner Mirabegron og Tamsulosin for udstødning af urinledersten og forbedring af kliniske symptomer
This randomized controlled trial compares the efficacy and safety of four treatment strategies for ureteral stone expulsion: Mirabegron alone, Tamsulosin alone, a combination of both, and standard conservative care. Participants diagnosed with ureteral stones will be randomly assigned to one of these four groups. The primary objective is to evaluate the stone expulsion rate within 4 weeks. The study also assesses time to expulsion, pain intensity, analgesic use, and potential side effects.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
This study aims to compare the efficacy of Mirabegron, Tamsulosin, their combination, and standard conservative management in facilitating ureteral stone expulsion, as well as to evaluate their impact on clinical symptoms.
The primary objective is to analyze the differences in the stone expulsion rate within four weeks among four treatment groups:
Group A: Mirabegron 50 mg daily.
Group B: Tamsulosin 0.4 mg daily.
Group C: Combination of Mirabegron 50 mg and Tamsulosin 0.4 mg daily.
Group D: Standard of care (symptomatic control). For acute colic, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as Ketorolac or Diclofenac are the first-line treatment. If patients have allergies or contraindications to NSAIDs, alternative analgesics such as Tramadol or Acetaminophen will be administered.
Secondary objectives include comparing the time to stone expulsion, changes in pain intensity (assessed by Visual Analog Scale), consumption of analgesic medication, and the impact of different treatments on patient fatigue (assessed by the Fatigue Symptom Inventory, FSI).
Additionally, the study will collect and analyze adverse events occurring during the treatment period, such as palpitations, blood pressure changes, and headaches, to evaluate the safety of each intervention. The results are expected to provide comprehensive options for Medical Expulsive Therapy (MET), offering alternative non-invasive strategies for patients intolerant to traditional alpha-blockers.
Undersøgelsestype
Tilmelding (Anslået)
Fase
- Fase 4
Kontakter og lokationer
Studiekontakt
- Navn: Shu-Yu Wu, Doctor of Medicine
- Telefonnummer: 60146 +886-2-6628-9779
- E-mail: nobookrain2014@gmail.com
Studiesteder
-
-
-
New Taipei City, Taiwan, 231
- Rekruttering
- Taipei Tzu Chi Hospital
-
Kontakt:
- Shu-Yu Wu, MD
- Telefonnummer: 60146 +886-2-6628-9779
- E-mail: nobookrain2014@gmail.com
-
Kontakt:
- WAN-LING YOUNG, Bachelor of Science in Nursing
- Telefonnummer: 64124 +886-2-6628-9779
- E-mail: lisayoung1345@gmail.com
-
Ledende efterforsker:
- Shu-Yu Wu, MD
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Age and Sex: Adult patients aged 18 to 75 years, inclusive of both males and females.
- Diagnosis: Unilateral ureteral stone confirmed by Computed Tomography (CT), Renal Sonography, or Kidney-Ureter-Bladder (KUB) radiography.
- Stone Characteristics: Stone size between 4 mm and 10 mm; located in the upper (proximal), middle, or lower (distal) ureter.
- Symptoms and Renal Function: Presence of renal colic or hematuria, with no severe renal insufficiency (eGFR > 60 mL/min/1.73m²).
Exclusion Criteria:
- Urinary tract infection (UTI).
- Multiple or bilateral ureteral stones.
- Ureteral stones not visible on KUB radiography (radiolucent stones).
- Pregnant or lactating women.
- Severe hydronephrosis.
- Renal insufficiency (defined as eGFR < 30 mL/min/1.73m² or Serum Creatinine > 2 mg/dL).
- Uncontrolled hypertension or major cardiovascular disease.
- Patients who refuse Medical Expulsive Therapy (MET).
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Eksperimentel: Group A: Mirabegron
Patients receive Mirabegron 50 mg daily. |
50 mg tablet orally once daily. |
|
Aktiv komparator: Group B: Tamsulosin
Patients receive Tamsulosin 0.4 mg daily. |
0.4 mg tablet orally once daily. |
|
Eksperimentel: Group C: Combination
Patients receive Mirabegron 50mg and Tamsulosin 0.4mg daily. |
50 mg tablet orally once daily. 0.4 mg tablet orally once daily. |
|
Ingen indgriben: Group D: Standard of Care
Patients receive standard conservative management (symptomatic control with NSAIDs/analgesics on demand). |
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Stone Expulsion Rate
Tidsramme: Up to 4 weeks
|
The proportion of participants with complete stone expulsion confirmed by KUB or CT scan. Successful expulsion is defined as the absence of stone fragments or the presence of clinically insignificant fragments. |
Up to 4 weeks
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Time to Stone Expulsion
Tidsramme: Up to 4 weeks
|
The number of days from randomization to the confirmation of complete stone expulsion. |
Up to 4 weeks
|
|
Change in Pain Intensity
Tidsramme: Baseline and up to 4 weeks
|
Assessed using the Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst possible pain). |
Baseline and up to 4 weeks
|
|
Total Analgesic Consumption
Tidsramme: Up to 4 weeks
|
The total amount of analgesic medication (e.g., NSAIDs, Tramadol, Acetaminophen) consumed by the participant to control pain. |
Up to 4 weeks
|
|
Change in Fatigue Symptoms
Tidsramme: Baseline and up to 4 weeks
|
Assessed using the Fatigue Symptom Inventory (FSI) to measure the intensity and interference of fatigue. |
Baseline and up to 4 weeks
|
|
Incidence of Adverse Events
Tidsramme: Up to 4 weeks
|
Number of participants with treatment-related adverse events, such as palpitations, hypotension, dizziness, and headache. |
Up to 4 weeks
|
Samarbejdspartnere og efterforskere
Efterforskere
- Ledende efterforsker: Shu-Yu Wu, MD, Taichung Tzu Chi Hospital
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Anslået)
Studieafslutning (Anslået)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Urogenitale sygdomme
- Mandlige urogenitale sygdomme
- Calculi
- Patologiske Tilstande, Anatomiske
- Urologiske sygdomme
- Urogenitale sygdomme hos kvinder
- Kvinders urogenitale sygdomme og graviditetskomplikationer
- Urolithiasis
- Urinvejsregning
- Ureterale sygdomme
- Patologiske tilstande, tegn og symptomer
- Ureterolithiasis
- Ureteralregning
- Svovlforbindelser
- Organiske kemikalier
- Kulbrinter
- Kulbrinter, cyklisk
- Kulbrinter, aromatisk
- Amider
- Benzenderivater
- Benzenesulfonamider
- Sulfonamider
- Sulfoner
- Tamsulosin
- Mirabegron
Andre undersøgelses-id-numre
- 14-IRB074
- TCRD-TPE-115-35 (Andet bevillings-/finansieringsnummer: Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Individual participant data will not be shared to protect patient confidentiality. All relevant data will be reported in the final study publication in aggregate form.
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