Oral diclofenac in the prophylactic treatment of recurrent renal colic. A double-blind comparison with placebo.
We have conducted a double-blind, randomized, placebo-controlled trial with oral diclofenac to study the prophylactic effect on renal colic recurrence and spontaneous stone expulsion rate. Forty-one patients were given 50 mg oral diclofenac 3 times a day for 7 days after being discharged for a colic episode from Oslo Emergency Hospital (< 24 h stay) and 39 patients were given matching placebo tablets. The number of new renal colic episodes per accumulated patient treatment days was 64/287 in the diclofenac group and 119/273 in the placebo group (p < 0.01). This difference was greatest during the first 4 treatment days. A similar trend was found for pain intensity (0-10 cm VAS) with the greatest difference on day 1 (4.3 vs. 2.8, p = 0.05). Side effects, mainly gastrointestinal, were reported for 14% of the treatment days in both treatment groups. Stone expulsion rate was almost identical (28 vs. 29 days), regardless of stone size. Readmission rate to Oslo Emergency Hospital/other hospitals were 10 and 67% (p < 0.001). In conclusion, oral treatment with diclofenac was effective as short-term prophylaxis of new colic episodes, especially during the first 4 days, and reduces the number of hospital readmissions significantly. The stone passage rate appears not to be affected.
Laerum
E
E
Department of General Practice, University of Oslo, Norway.
Ommundsen
O E
OE
Grønseth
J E
JE
Christiansen
A
A
Fagertun
H E
HE
D000284:Administration, Oral; D000328:Adult; D000704:Analysis of Variance; D003085:Colic / Q000188:drug therapy*; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D004008:Diclofenac / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000008:administration & dosage / Q000627:therapeutic use; D007669:Kidney Calculi / Q000188:drug therapy*; D008297:Male; D010919:Placebos; D012008:Recurrence
D016861:Cyclooxygenase Inhibitors; D010919:Placebos; D004008:Diclofenac; D007213:Indomethacin