SUSPEND

Use of drug therapy in the management of symptomatic ureteric stones in hospitalised adults: a multicentre placebo controlled randomised trial of a calcium channel blocker (nifedipine) and an alpha-blocker (tamsulosin)  

Kidney stone disease is a common health problem affecting about 1.6 million adults in the UK.  In some patients the stone will fall out of the kidney and become lodged in the tube (ureter) between the kidney and bladder.  The majority of sufferers experience a sudden episode of prolonged abdominal pain, usually sufficiently severe to need emergency admission to hospital.  Given the pain experienced passing a ureteric stone and the high cost of having to remove them, any simple treatment that hastens or increases the chance of spontaneous stone passage would be welcomed by both patients and the NHS. 

Stones are expelled by rhythmic tightening (contraction) and opening (relaxation) of the ureter which moves the stone downwards and out of the body.  Stones may get stuck because the ureter downstream of the stone fails to relax to allow it through; suggesting that relaxant drugs may hasten stone passage. Recently two different relaxant drugs have undergone early testing for this purpose; tamsulosin (an alpha blocker) and nifedipine (a calcium channel blocker).  These drugs are widely used for other health problems with a good safety profile and can be taken as once daily capsules. Preliminary results are encouraging with both drugs seeming to increase the chance of passing the stone by 50% and speed the process up by 4 days.  

The SUSPEND trial involves giving one of three alternative treatments - tamsulosin, nifedipine or dummy tablet (placebo) to 1200 people who have been diagnosed with ureteric stones and have agreed to take part in the trial.  The main thing we will measure is whether the stone passes on its own or whether further intervention is required to remove the stone.  Other things that we will be determining is how much pain each participant experiences and what effect this has on quality of life. 

This is a UK Collaborative Study funded by the NIHR HTA Programme 

Please follow this link to the trial website:- 

https://viis.abdn.ac.uk/HSRU/suspend/

For more information regarding The SUSPEND Trial please contact Kath Starr on 01224 438120 or email: k.starr@abdn.ac.uk