Comparison of Mirabegron and Tamsulosin for Ureteral Stone Expulsion

NCT ID: NCT07310797

Last Updated: 2025-12-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-01

Study Completion Date

2030-12-31

Brief Summary

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This randomized controlled trial compares the efficacy and safety of four treatment strategies for ureteral stone expulsion: Mirabegron alone, Tamsulosin alone, a combination of both, and standard conservative care. Participants diagnosed with ureteral stones will be randomly assigned to one of these four groups. The primary objective is to evaluate the stone expulsion rate within 4 weeks. The study also assesses time to expulsion, pain intensity, analgesic use, and potential side effects.

Detailed Description

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This study aims to compare the efficacy of Mirabegron, Tamsulosin, their combination, and standard conservative management in facilitating ureteral stone expulsion, as well as to evaluate their impact on clinical symptoms.

The primary objective is to analyze the differences in the stone expulsion rate within four weeks among four treatment groups:

Group A: Mirabegron 50 mg daily.

Group B: Tamsulosin 0.4 mg daily.

Group C: Combination of Mirabegron 50 mg and Tamsulosin 0.4 mg daily.

Group D: Standard of care (symptomatic control). For acute colic, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as Ketorolac or Diclofenac are the first-line treatment. If patients have allergies or contraindications to NSAIDs, alternative analgesics such as Tramadol or Acetaminophen will be administered.

Secondary objectives include comparing the time to stone expulsion, changes in pain intensity (assessed by Visual Analog Scale), consumption of analgesic medication, and the impact of different treatments on patient fatigue (assessed by the Fatigue Symptom Inventory, FSI).

Additionally, the study will collect and analyze adverse events occurring during the treatment period, such as palpitations, blood pressure changes, and headaches, to evaluate the safety of each intervention. The results are expected to provide comprehensive options for Medical Expulsive Therapy (MET), offering alternative non-invasive strategies for patients intolerant to traditional alpha-blockers.

Conditions

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Ureteral Calculi

Keywords

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Mirabegron Tamsulosin Medical Expulsive Therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants are randomly assigned to one of four parallel treatment groups.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group A: Mirabegron

Patients receive Mirabegron 50 mg daily.

Group Type EXPERIMENTAL

Mirabegron

Intervention Type DRUG

50 mg tablet orally once daily.

Group B: Tamsulosin

Patients receive Tamsulosin 0.4 mg daily.

Group Type ACTIVE_COMPARATOR

Tamsulosin

Intervention Type DRUG

0.4 mg tablet orally once daily.

Group C: Combination

Patients receive Mirabegron 50mg and Tamsulosin 0.4mg daily.

Group Type EXPERIMENTAL

Mirabegron

Intervention Type DRUG

50 mg tablet orally once daily.

Tamsulosin

Intervention Type DRUG

0.4 mg tablet orally once daily.

Group D: Standard of Care

Patients receive standard conservative management (symptomatic control with NSAIDs/analgesics on demand).

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Mirabegron

50 mg tablet orally once daily.

Intervention Type DRUG

Tamsulosin

0.4 mg tablet orally once daily.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Age and Sex: Adult patients aged 18 to 75 years, inclusive of both males and females.
2. Diagnosis: Unilateral ureteral stone confirmed by Computed Tomography (CT), Renal Sonography, or Kidney-Ureter-Bladder (KUB) radiography.
3. Stone Characteristics: Stone size between 4 mm and 10 mm; located in the upper (proximal), middle, or lower (distal) ureter.
4. Symptoms and Renal Function: Presence of renal colic or hematuria, with no severe renal insufficiency (eGFR \> 60 mL/min/1.73m²).

Exclusion Criteria

1. Urinary tract infection (UTI).
2. Multiple or bilateral ureteral stones.
3. Ureteral stones not visible on KUB radiography (radiolucent stones).
4. Pregnant or lactating women.
5. Severe hydronephrosis.
6. Renal insufficiency (defined as eGFR \< 30 mL/min/1.73m² or Serum Creatinine \> 2 mg/dL).
7. Uncontrolled hypertension or major cardiovascular disease.
8. Patients who refuse Medical Expulsive Therapy (MET).
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation

OTHER

Sponsor Role lead

Responsible Party

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Shu-Yu Wu

Attending Physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Shu-Yu Wu, MD

Role: PRINCIPAL_INVESTIGATOR

Taichung Tzu Chi Hospital

Locations

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Taipei Tzu Chi Hospital

New Taipei City, , Taiwan

Site Status

Countries

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Taiwan

Central Contacts

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Shu-Yu Wu, Doctor of Medicine

Role: CONTACT

Phone: +886-2-6628-9779

Email: [email protected]

Facility Contacts

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Shu-Yu Wu, MD

Role: primary

WAN-LING YOUNG, Bachelor of Science in Nursing

Role: backup

Other Identifiers

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TCRD-TPE-115-35

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

14-IRB074

Identifier Type: -

Identifier Source: org_study_id