Desmopressin effectiveness in renal colic pain management: Systematic review and meta-analysis.
OBJECTIVE
This meta-analysis of trials was conducted to evaluate the impact of desmopressin on renal colic pain relief in comparison to more typically used medications (opioids and nonsteroidal anti-inflammatory drugs [NSAIDs]).


METHODS
PubMed, EMbase, Scopus, CINHAL, and Cochrane Central Register of Controlled Trials were searched for clinical trials. Pain reduction and need for rescue treatment were the outcomes of interest.


RESULTS
Ten studies met our inclusion criteria and were analyzed. Pooling of data showed that, on a scale of 1-10, pain reduction after 30 minutes was significantly higher in NSAID in comparison to desmopressin (3.39 with a 95% confidence interval [CI] of 4.62-2.16; P<.01), but this reduction was not significantly different between NSAID and desmopressin-NSAID combination (-0.28 with 95% CI of -0.62 to 0.05; P=.01). Summary of relative risk (RR) for the need for rescue treatment in desmopressin in comparison to NSAID was 0.31 with a 95% CI of 0.13-0.74 and a significant RR (P<.04), but no difference was shown in desmopressin-NSAID combination in comparison to NSAID (0.70 with a 95% CI of 0.49-1.00; P<.19). On this outcome, desmopressin in comparison to opioid showed insignificant RR (1.82 with a 95% CI of 0.36-4.34; P=.72), but this need in desmopressin in comparison to desmopressin-opioid combination was 0.75 with a 95% CI of 0.56-0.99 and a significant RR (P=.042).


CONCLUSIONS
In conclusion, the results of this systematic review suggest that, according to the present low-quality studies, desmopressin can be used as an adjuvant therapy in renal colic management in combination with opioids.
Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad
M
Jalili
Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Pouya
P
Entezari
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Amin
A
Doosti-Irani
Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran.
Rasoul
R
Masoomi
Emergency Medicine Research Center, Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: H-Mirfazaelian@sina.tums.ac.ir.
Hadi
H
Mirfazaelian
D050034:Antidiuretic Agents / Q000627:therapeutic use; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D006801:Humans; D059408:Pain Management / Q000379:methods*; D056844:Renal Colic / Q000188:drug therapy*; D016896:Treatment Outcome
D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin