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Clinical efficacy of Spasmofen® suppository in the emergency treatment of renal colic: a randomized, double-blind, double-dummy comparative trial.
Drug Des Devel Ther 2014; 8:405-10DD

Abstract

BACKGROUND

Renal colic is typically characterized by the sudden onset of severe pain radiating from the flank to the groin and its acute management in emergency departments essentially aims at rapid pain relief. Spasmofen(®) is a brand of Amriya Pharmaceutical Industries in the form of rectal suppositories containing ketoprofen 100 mg and hyoscine butylbromide 10 mg. This combination is intended for the rapid relief of severe colicky pain in the renal system, hepatobiliary system, or gastrointestinal tract. This trial aims to compare a single-dose of Spasmofen rectal suppository to a single intravenous (IV) ketorolac tromethamine 30 mg/2 mL dose in patients with acute renal colic.

METHODS

A total of 80 eligible consecutive patients presenting to the emergency departments of two medical centers with acute renal colic were included in the study. Eligible patients who signed the informed consent were randomly assigned into two treatment groups: an experimental group (Spasmofen group) who received one Spasmofen rectal suppository plus an IV injection of 2 mL of normal saline solution; and a control group (ketorolac group) who received one ketorolac 30 mg/2 mL ampoule IV plus one placebo suppository. Treatment success, defined as a change in the verbal rating score from severe or moderate pain to none or mild at 60 minutes after the dose, was compared between groups using the chi-square/Fisher's exact test. Percentage reductions in visual pain analog scale (VPAS) scores at 15 and 60 minutes after the dose were compared between groups using the Z-test for proportions.

RESULTS

Successful treatment at 60 minutes occurred in 35 of 40 (87.5%) of Spasmofen-treated patients and in 33 of 40 (82.5%) of ketorolac-treated patients. The difference was not statistically significant by Fisher's exact test (P=0.755). The mean percentage reduction of VPAS after 15 minutes was 61.82% in the Spasmofen-treated group and 64.76% in the ketorolac-treated group. The difference was also not statistically significant by the Z-test for proportions (P=0.795). Sixty minutes after being treated, Spasmofen was associated with a statistically significant greater reduction in VPAS (mean% reduction =92.36%) than ketorolac (75.06%; P=0.0466).

CONCLUSION

Single-dose Spasmofen rectal suppository might be a safe and effective first-aid treatment for the emergency department relief of acute renal colic.

Authors+Show Affiliations

Green Clinic and Research Center, Alexandria, Egypt.Alexandria Helmy Medical Center, Alexandria, Egypt.Alexandria Helmy Medical Center, Alexandria, Egypt.Pharco Corporation, Alexandria, Egypt.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

24851039

Citation

Yakoot, Mostafa, et al. "Clinical Efficacy of Spasmofen® Suppository in the Emergency Treatment of Renal Colic: a Randomized, Double-blind, Double-dummy Comparative Trial." Drug Design, Development and Therapy, vol. 8, 2014, pp. 405-10.
Yakoot M, Salem A, Yousef S, et al. Clinical efficacy of Spasmofen® suppository in the emergency treatment of renal colic: a randomized, double-blind, double-dummy comparative trial. Drug Des Devel Ther. 2014;8:405-10.
Yakoot, M., Salem, A., Yousef, S., & Helmy, S. (2014). Clinical efficacy of Spasmofen® suppository in the emergency treatment of renal colic: a randomized, double-blind, double-dummy comparative trial. Drug Design, Development and Therapy, 8, pp. 405-10. doi:10.2147/DDDT.S62571.
Yakoot M, et al. Clinical Efficacy of Spasmofen® Suppository in the Emergency Treatment of Renal Colic: a Randomized, Double-blind, Double-dummy Comparative Trial. Drug Des Devel Ther. 2014;8:405-10. PubMed PMID: 24851039.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical efficacy of Spasmofen® suppository in the emergency treatment of renal colic: a randomized, double-blind, double-dummy comparative trial. AU - Yakoot,Mostafa, AU - Salem,Amel, AU - Yousef,Sameh, AU - Helmy,Sherine, Y1 - 2014/05/02/ PY - 2014/5/23/entrez PY - 2014/5/23/pubmed PY - 2014/12/15/medline KW - RCT KW - hyoscine butylbromide KW - ketoprofen KW - ketorolac KW - renal colic SP - 405 EP - 10 JF - Drug design, development and therapy JO - Drug Des Devel Ther VL - 8 N2 - BACKGROUND: Renal colic is typically characterized by the sudden onset of severe pain radiating from the flank to the groin and its acute management in emergency departments essentially aims at rapid pain relief. Spasmofen(®) is a brand of Amriya Pharmaceutical Industries in the form of rectal suppositories containing ketoprofen 100 mg and hyoscine butylbromide 10 mg. This combination is intended for the rapid relief of severe colicky pain in the renal system, hepatobiliary system, or gastrointestinal tract. This trial aims to compare a single-dose of Spasmofen rectal suppository to a single intravenous (IV) ketorolac tromethamine 30 mg/2 mL dose in patients with acute renal colic. METHODS: A total of 80 eligible consecutive patients presenting to the emergency departments of two medical centers with acute renal colic were included in the study. Eligible patients who signed the informed consent were randomly assigned into two treatment groups: an experimental group (Spasmofen group) who received one Spasmofen rectal suppository plus an IV injection of 2 mL of normal saline solution; and a control group (ketorolac group) who received one ketorolac 30 mg/2 mL ampoule IV plus one placebo suppository. Treatment success, defined as a change in the verbal rating score from severe or moderate pain to none or mild at 60 minutes after the dose, was compared between groups using the chi-square/Fisher's exact test. Percentage reductions in visual pain analog scale (VPAS) scores at 15 and 60 minutes after the dose were compared between groups using the Z-test for proportions. RESULTS: Successful treatment at 60 minutes occurred in 35 of 40 (87.5%) of Spasmofen-treated patients and in 33 of 40 (82.5%) of ketorolac-treated patients. The difference was not statistically significant by Fisher's exact test (P=0.755). The mean percentage reduction of VPAS after 15 minutes was 61.82% in the Spasmofen-treated group and 64.76% in the ketorolac-treated group. The difference was also not statistically significant by the Z-test for proportions (P=0.795). Sixty minutes after being treated, Spasmofen was associated with a statistically significant greater reduction in VPAS (mean% reduction =92.36%) than ketorolac (75.06%; P=0.0466). CONCLUSION: Single-dose Spasmofen rectal suppository might be a safe and effective first-aid treatment for the emergency department relief of acute renal colic. SN - 1177-8881 UR - https://www.unboundmedicine.com/medline/citation/24851039/Clinical_efficacy_of_Spasmofen®_suppository_in_the_emergency_treatment_of_renal_colic:_a_randomized_double_blind_double_dummy_comparative_trial_ L2 - https://dx.doi.org/10.2147/DDDT.S62571 DB - PRIME DP - Unbound Medicine ER -