Medically expulsive therapy (MET) has no benefit in improving spontaneous stone passage (SSP) in patients presenting with acute ureteric colic: Results from the MIMIC study

Shah, Tuhin; Gao, Chen; O'Keefe, Ainsley; Manning, Todd; Peacocke, A.; Cashman, Sophia; Nambiar, A.; Ben, Liu; Cumberbatch, Marcus; Ivin, N.; Maw, Jennifer; Abdaal, C. Ali; Hayek, Shlomo; Christidis, Daniel; Bolton, D.; Lawrentschuk, Nathan; Khan, S.; Demirel, Serdar; Graham, Sarah; Lee, J.C.M.; Evans, Stuart; Koschel, Samantha; Badgery, Henry; Wang, L.; Nzenza, Tatenda; Ruljancich, Paul; Begum, Rehana; Hamad, Shaikha; Shetty, Ashok B.; Swallow, D.; Morrow, Jon S.; Curry, Dennis E.; Young, Mary Lynn; Abboudi, Hamid; Jalil, Rumana; Dasgupta, Rituparna; Cameron, Fiona; Shingles, C.; C, Ho; Parwaiz, Iram; Henderson, John; MacKenzie, Kenneth; Reid, Kevin; Umez-Eronini, Nkem; Assaf, Nazrin; Oyekan, A.; Sriprasad, Seshadri; Hayat, Zara; Morrison‐Jones, Victoria; Steen, Christopher; Vilchez, Miguel Enrique Alberto; Rujancich, P.; Laird, Arthur T.; Sharma, Ashish; Phipps, Simon; Harris, A.; Rogers, Ann E.; Ngweso, Simeon; Nyandoro, Munyaradzi G; Hayne, Dickon; Hendry, Jane; Kerr, Lachlan; McIlhenny, Craig; Rodger, Flora; Docherty, Elizabeth; Ng, A.; Seaward, L.; Eldred‐Evans, David; Bultitude, Matthew; Abdelmoteleb, Haitham; Hawary, Amr; Tregunna, Rebecca; Ibrahim, H.; Grath, S. Mc; Campbell, Andrew; Cronbach, P.; Bdesha, Amarjit; Suraparaj, L.; O’Brien, J.; Gupta, Sajal; Tait, Catherine; Sakthivel, Ashok; Pankhania, Rahul; Al-Qassim, Zubair; Řezáčová, Monika; Edison, Eric; Sandhu, Seerat; Foley, Rob; Akintimehin, Abisoye; Khan, Aftab Alam; Nkwam, N.; Grice, Peter; Khan, Masood; Kashora, Florence; Manson-Bahr, David; Cauley, Nadine Mc; Nehikhare, Y.; Bycroft, John; Tailor, Kishan; Saleemi, A; Al-Dhahir, W.; Yousif, Mohammad; O’Rourke, James S.; Chin, Awt; Pearce, Ian; Olivier, James; Tay, Jia Ying Isaac; Cannon, Alexa C.; Akman, James; Hussain, Zamir; Coode-Bate, Jack; Natarajan, M.; Irving, Stuart; Murtagh, Kevin; Carrie, Augusto; Miller, Megan; Malki, Manar; Burge, Frank Walton; Ratan, H.; Bedi, Navpreet Singh; Kavia, Rajesh; Stonier, Thomas; Simson, Nick; Singh, H.; Hatem, Engin; Arya, MC; Sadien, Iannish; Miakhil, I.; Sharma, Sunil Dutt; Olaniyi, Popoola Abiodun; Stammeijer, Roelof; Mason, H. Monck; Symes, Andrew; Lavan, Lisa; Rowbotham, C.; Wong, CS; Al-Shakhshir, Sarah; Belal, Md. Towhid; Kay, Alan; Graham, J.; Simmons, L.; Khadouri, Sinan; Withington, John; Ajayi, Leye; Tay, Li June; Ward, A. S.; Parys, B. T.; Liew, Ming Na; Simpson, Rachel E.; Ross, Donald E.; Adams, Rachel; Mirza, Asfand Baig; Acher, Peter; Gallagher, M.; Premakumar, Yaamini; Ager, Michael; Ayres, B.; Pang, Kit Yi Kristine; Patterson, J.; Kozan, Abdulbaki; Jaffer, Ata; Din, W.; Biyani, C. S.; Tam, Justina; Tudor, Edward; Probert, John L.; Matanhelia, Mudit; Hegazy, Mohammed; Quinlan, David; Ness, Daniel T.; Gowardhan, Bharat; Bateman, Kim; Woźniak, Sławomir; Ellis, Gidon; Derbyshire, Laura; Chow, Ken; Mosey, Rebecca; Osman, Banan; Kynaston, Howard; Clements, Joshua; Hann, G; Gray, S; Yassaie, Omid; Weeratunga, George; Udovichich, C.; Mbuvi, James; Stewart, Heather; Samsudin, Azizan; Hughes-Hallet, A.; Kum, Francesca; Symes, Rebecca; Frymann, R.; Chappell, Barnaby; Rezvani, Seyed M. H. S.; Ahmed, Ibrar; Shergill, Iqbal; Lee, S.; Hussain, Apheera; Pickard, Rawson J.; Erotocritou, Paul; Smith, D.; Kasivisvanathan, Veeru

doi:10.1016/s1569-9056(18)31472-6

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“… examined 1 028 patients discharged from a US emergency department, where, serendipitously, 50% were prescribed MET and 50% were not, and found that rate of surgery was identical. The recent MIMIC trial found no beneficial effect of MET in a 71‐centre UK collaborative, which examined 3 127 patients conservatively managed for ureteric colic . The present study is unique in actually withdrawing MET from protocols and comparing whole cohorts over time, but the observations of lack of efficacy are consistent.…”

Section: Discussionsupporting

confidence: 50%

Beyond medical expulsive therapy: evolution to supported stone passage for ureteric stones

Portis

Borofsky

et al. 2018

BJU International

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Section: Discussionsupporting

confidence: 50%

Beyond medical expulsive therapy: evolution to supported stone passage for ureteric stones

Portis

Borofsky

et al. 2018

BJU International

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“…Thereof 80% (n=2,516) of the patients had a spontaneous stone passage and were included in a multivariable analysis including MET use, age, gender, stone size and stone position. They did show no significant association of MET use with spontaneous stone passage irrespective of stone size or location in the ureter (9). But as the results aren't published so far we still need to await final release to consider these findings in our daily practice.…”

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confidence: 94%

The status of medical expulsive therapy in the age of evidence-based medicine

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Seitz²

2018

Ann. Transl. Med

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Medically expulsive therapy (MET) has no benefit in improving spontaneous stone passage (SSP) in patients presenting with acute ureteric colic: Results from the MIMIC study

Cited by 2 publications

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Beyond medical expulsive therapy: evolution to supported stone passage for ureteric stones

Beyond medical expulsive therapy: evolution to supported stone passage for ureteric stones

The status of medical expulsive therapy in the age of evidence-based medicine

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