Parecoxib vs Paracetamol for Treatment of Acute Renal Colic due to Ureteric Calculi: A Randomized Controlled Trial
Abstract
OBJECTIVES
To compare efficacy and safety of parecoxib and paracetamol for treatment of acute renal colic due to ureteric stones.
PATIENTS AND METHODS
A randomized, double blinded, controlled trial included adult patients presented to emergency department with acute renal colic due to ureteric calculi between June 2019 and August 2020. Patients with hypersensitivity to either drug, peptic ulcer, coronary ischemia, peripheral vascular or cerebrovascular disease, hepatic impairment (Child-Pugh score >10) or chronic kidney disease stage 4 or 5 were excluded. Eligible patients were randomized to group 1 who received 1g intravenous Paracetamol infusion or group 2 who received 40mg intravenous Parecoxib infusion. Pain analogue score (PAS) was evaluated before treatment and 30 minutes afterwards. The primary endpoint was the need for rescue analgesia for persistent pain. Safety was evaluated by the incidence of adverse events.
RESULTS
The study included 203 patients (102 in group 1 and 101 in group 2). Pretreatment patients' data were comparable for both groups. The mean PAS decrease from 7.6 to 3.8 in paracetamol group (P<0.001) and from 7.8 to 3.4 in parecoxib group (P<0.001). Rescue analgesia were needed in 36 patients (35.3%) in paracetamol group and 27 patients (26.7%) in parecoxib group (P=0.187). Minor adverse events developed in two patients (2%) in paracetamol group and three patients (3%) in parecoxib group (P=0.683).
CONCLUSIONS
Paracetamol and Parecoxib were effective…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 203 participants or records.
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