Dados do Trabalho

Título

Mirabegron efficacy as medical expulsive therapy for distal ureteral stones: a systematic review of the literature, meta-analysis and trial sequential analysis

Resumo

Introduction: Medical expulsive therapy (MET) is recommended for distal ureteral stones from 5 to 10 mm. Mirabegron is a medication with potential improvement in Stone Expulsion Rate (SER) and Stone Expulsion Time (SET). The purpose of this study is to assess the effectiveness of Mirabegron against placebo for medical expulsion therapy for distal ureteral stones.
Materials and Methods: A comprehensive literature search was conducted on PUBMED, EMBASE, and Cochrane Central Register of Controlled Trials, from inception until December 2023. Only randomized controlled trials were included in the analysis.
Results: Five publications encompassing 419 patients were included. We observed has no difference in SER (RR 1.49, CI 95% 0.91;2.45, p=0,08, I2 = 53%), SET (MD -1.92, CI 95% - 5,38; 1,54, p<0,01, I2 = 95%) and analgesic use episodes (MD -1.03, CI 95% -2.16;0,09, p=<0,01, I2 = 89%). In trial sequential analysis we observed that there is still no sufficient RCTs to infer the effect of mirabegron, but accumulated data is close to futility boundary, so probably one more RCT should be enough to properly determine mirabegron effect on SER.
Conclusion: Mirabegron presented no benefit in medical expulsive therapy for patients with distal ureteral stones from 5 to 10 mm.

Palavras Chave

Mirabegron; distal ureteric stones; ureteral stones