The authors found no evidence that the drugs reduced pain, hastened time to stone passage, or improved health status. About 80% of patients in each group did not require additional interventions to assist with stone passage. Serious adverse events were reported in three participants in the nifedipine group and one in the placebo group.
Commenting about the study in the NEJM Journal Watch, family physician Bruce Soloway, MD, wrote: “This trial, designed to reflect current recommendations and clinical practice, not only definitively demonstrates the ineffectiveness of medical expulsive therapy for ureteral stones but also reaffirms the essential importance of large, well-designed, randomized trials for assessing clinical interventions and formulating treatment guidelines.”
Separately, in commentary also published online in The Lancet (May 18, 2015), Jean de la Rosette, MD, and M. Pilar Laguna, MD, PhD, of AMC University Hospital, Amsterdam, the Netherlands, wrote: “This study… removes, beyond any reasonable doubt, any positive expectations with respect to α blockers in the treatment of ureter stones.”