Increasing Nonsteroidal Anti-inflammatory Drugs and Reducing Opioids or Paracetamol in the Management of Acute Renal Colic: Based on Three-Stage Study Design of Network Meta-Analysis of Randomized Controlled Trials.


:Background: Currently, although non-steroidal anti-inflammatory drugs (NSAIDs) were recommended for acute renal colic in the 2018 European Association of Urology guidelines, there are no specific NSAIDs and no specific routes of administration in this guideline. The clinical practice of advocating intravenous opioids as the initial analgesia is still common out of the fear of adverse events from NSAIDs. Objectives: To comprehensively assess the efficacy and safety of NSAIDs, opioids, paracetamol, and combination therapy for acute renal colic. Methods: Ovid MEDLINE, Ovid EMbase, the Cochrane Library, Clinical Trials Registry Platform for, and WHO International Clinical Trials Registry Platform were searched through February 2, 2018. Two reviewers selected all randomized controlled trails (RCTs) regarding NSAIDs, opioids, paracetamol, combination therapy, and placebo were identified for analysis. We designed a three-stage strategy based on classification and pharmacological mechanisms in the first stage, routes of administration in the second stage, and specific drug branches with different routes in the third stage using network meta-analysis. The pain variance at 30 min was seen as the primary outcome. Results: 65 RCTs with 8633 participants were involved. Comparing different classification and pharmacological mechanisms, combination therapy with more adverse events was more efficient than NSAIDs for the primary outcomes. Opioids gave rise to more nonspecific adverse events and vomiting events. NSAIDs were superior to opioids, paracetamol, and combination therapy after a full consideration of all outcomes. Comparing different routes of administration, NSAIDs with IV or IM route ranked first from efficacy and safety perspective. Comparing different specific drug branches with different routes, ibuprofen via IV route, ketorolac via IV route and diclofenac via IM route were superior for the management of acute renal colic. The results from diclofenac using IM route were more than those from ibuprofen used with IV route and ketorolac with IV route. Conclusions: In patients with adequate renal function, diclofenac via the IM route is recommended for patients without risks of cardiovascular events. Ibuprofen and ketorolac with IV route potentially superior to diclofenac via IM route remain to be investigated. Combination therapy is an alternative choice for uncontrolled pain after the use of NSAIDs.


Front Pharmacol


Gu HY,Luo J,Wu JY,Yao QS,Niu YM,Zhang C




Has Abstract


2019-02-22 00:00:00








  • The Traditional Japanese Herbal Medicine Hachimijiogan Elicits Neurite Outgrowth Effects in PC12 Cells and Improves Cognitive in AD Model Rats via Phosphorylation of CREB.

    abstract::Hachimijiogan (HJG) is a traditional herbal medicine that improves anxiety disorders in patients with dementia. In this study, we tested the hypothesis that HJG exerts neurotrophic factor-like effects to ameliorate memory impairment in Alzheimer disease (AD) model rats. First, we describe that HJG acts to induce neuri...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Kubota K,Fukue H,Sato H,Hashimoto K,Fujikane A,Moriyama H,Watanabe T,Katsurabayashi S,Kainuma M,Iwasaki K

    更新日期:2017-11-21 00:00:00

  • Endothelin-1 Regulation of Exercise-Induced Changes in Flow: Dynamic Regulation of Vascular Tone.

    abstract::Although endothelin (ET)-1 is a highly potent vasoconstrictor with considerable efficacy in numerous vascular beds, the role of endogenous ET-1 in the regulation of vascular tone remains unclear. The perspective that ET-1 plays little role in the on-going regulation of vascular tone at least under physiologic conditio...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Rapoport RM,Merkus D

    更新日期:2017-10-24 00:00:00

  • Immune Checkpoint Inhibitor-Associated Cardiotoxicity: Current Understanding on Its Mechanism, Diagnosis and Management.

    abstract::Immune checkpoint inhibitors (ICIs) that target cytotoxic T lymphocyte antigen 4, programmed cell death-1, and PD-ligand 1 have revolutionized cancer treatment, achieving unprecedented efficacy in multiple malignancies. ICIs are increasingly being used in early cancer settings and in combination with various other typ...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章,评审


    authors: Zhou YW,Zhu YJ,Wang MN,Xie Y,Chen CY,Zhang T,Xia F,Ding ZY,Liu JY

    更新日期:2019-11-29 00:00:00

  • Novel Alkyl(aryl)-Substituted 2,2-Difluoro-6-(trichloromethyl)-2H-1,3,2-oxazaborinin-3-ium-2-uides: Synthesis, Antimicrobial Activity, and CT-DNA Binding Evaluations.

    abstract::The synthesis, antimicrobial activity evaluations, biomolecule-binding properties (DNA), and absorption and emission properties of a new series of (Z)-1,1,1-trichloro-4-alkyl(aryl)amino-4-arylbut-3-en-2-ones (4, 5) and 2,2-difluoro-3-alkyl(aryl)amino-4-aryl-6-(trichloromethyl)-2H-1,3,2-oxazaborinin-3-ium-2-uides (6, 7...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Rosa WC,Rocha IO,Rodrigues MB,Coelho HS,Denardi LB,Ledur PC,Zanatta N,Acunha TV,Iglesias BA,Bonacorso HG

    更新日期:2020-09-02 00:00:00

  • Inhibition of Human Neutrophil Extracellular Trap (NET) Production by Propofol and Lipid Emulsion.

    abstract::Uncontrolled bacteremia is a common and life threatening condition that can lead to sepsis and septic shock with significant morbidity and mortality. Neutrophil granulocytes, the most abundant phagocytic leukocyte of the innate immune system, play an essential role in capturing and killing invading pathogens. Their an...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Meier A,Chien J,Hobohm L,Patras KA,Nizet V,Corriden R

    更新日期:2019-04-05 00:00:00

  • Hepatoprotective Effect of San-Cao Granule on Con A-Induced Liver Injury in Mice and Mechanisms of Action Exploration.

    abstract::Objective: San-Cao granule (SCG), a traditional Chinese herb formula, has been used for treating autoimmune hepatitis (AIH) in our clinics for a long time. However, its active ingredients and mechanisms of action were still unknown due to its complicated chemical compositions. In the present study, the pharmacological...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Yang Y,Zhang P,Wang Y,Wei S,Zhang L,Wang J,Lu X,Zhou H,Li R,Wen J,Zhou X,Li H,Li K,Zhao Y

    更新日期:2018-06-12 00:00:00

  • Corrigendum: Mequindox Induced Genotoxicity and Carcinogenicity in Mice.

    abstract::[This corrects the article DOI: 10.3389/fphar.2018.00361.]. ...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章,已发布勘误


    authors: Liu Q,Lei Z,Wu Q,Huang D,Xie S,Wang X,Pan Y,Yuan Z

    更新日期:2018-11-29 00:00:00

  • Serum Metabolic Profiling Reveals the Antidepressive Effects of the Total Iridoids of Valeriana jatamansi Jones on Chronic Unpredictable Mild Stress Mice.

    abstract:Background:Depression is a long-term complex psychiatric disorder, and its etiology remains largely unknown. Valeriana jatamansi Jones ex Roxb (V. jatamansi) is used in the clinic for the treatment of depression, but there are insufficient reports of its antidepressive mechanisms and a poor understanding of its endogen...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Li Y,Wu L,Chen C,Wang L,Guo C,Zhao X,Zhao T,Wang X,Liu A,Yan Z

    更新日期:2020-03-20 00:00:00

  • The Anti-neuroinflammatory Activity of Tectorigenin Pretreatment via Downregulated NF-κB and ERK/JNK Pathways in BV-2 Microglial and Microglia Inactivation in Mice With Lipopolysaccharide.

    abstract::The activation of microglia is decisively involved with the neurodegeneration observed in many neuroinflammatory pathologies, such as multiple sclerosis, Parkinson's disease, and Alzheimer's disease. Tectorigenin (TEC) is an isoflavone isolated from various medicinal plants, such as Pueraria thunbergiana Benth, Belamc...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Lim HS,Kim YJ,Kim BY,Park G,Jeong SJ

    更新日期:2018-05-09 00:00:00

  • Human α-Defensin-5 Efficiently Neutralizes Clostridioides difficile Toxins TcdA, TcdB, and CDT.

    abstract::Infections with the pathogenic bacterium Clostridioides (C.) difficile are coming more into focus, in particular in hospitalized patients after antibiotic treatment. C. difficile produces the exotoxins TcdA and TcdB. Since some years, hypervirulent strains are described, which produce in addition the binary actin ADP-...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Korbmacher M,Fischer S,Landenberger M,Papatheodorou P,Aktories K,Barth H

    更新日期:2020-08-12 00:00:00

  • Therapeutic Anabolic and Anticatabolic Benefits of Natural Chinese Medicines for the Treatment of Osteoporosis.

    abstract::Osteoporosis is a bone disease characterized by increasing osseous fragility and fracture due to the reduced bone mass and microstructural degradation. Primary pharmacological strategies for the treatment of osteoporosis, hormone replacement treatment (HRT), and alendronate therapies may produce adverse side-effects a...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章,评审


    authors: He J,Li X,Wang Z,Bennett S,Chen K,Xiao Z,Zhan J,Chen S,Hou Y,Chen J,Wang S,Xu J,Lin D

    更新日期:2019-11-25 00:00:00

  • Comparative Evaluation of Prosopis cineraria (L.) Druce and Its ZnO Nanoparticles on Scopolamine Induced Amnesia.

    abstract::Over recent years, utilization of green synthesized nanomaterials has been widely growing on human body because of its special properties. With the increasing acceptance of nanoparticle approach for various clinical treatments, the biosafety and toxicological effects on the vital organs such as central nervous system,...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Yadav E,Singh D,Yadav P,Verma A

    更新日期:2018-05-23 00:00:00

  • Betulinic Acid Enhances the Viability of Random-Pattern Skin Flaps by Activating Autophagy.

    abstract::Random-pattern skin flap replantation is commonly used to repair skin defects during plastic and reconstructive surgery. However, flap necrosis due to ischemia and ischemia-reperfusion injury limits clinical applications. Betulinic acid, a plant-derived pentacyclic triterpene, may facilitate flap survival. In the pres...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Li J,Bao G,ALyafeai E,Ding J,Li S,Sheng S,Shen Z,Jia Z,Lin C,Zhang C,Lou Z,Xu H,Gao W,Zhou K

    更新日期:2019-09-13 00:00:00

  • Serotonin, neural markers, and memory.

    abstract::Diverse neuropsychiatric disorders present dysfunctional memory and no effective treatment exits for them; likely as result of the absence of neural markers associated to memory. Neurotransmitter systems and signaling pathways have been implicated in memory and dysfunctional memory; however, their role is poorly under...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章,评审


    authors: Meneses A

    更新日期:2015-07-21 00:00:00

  • Role of connexins in human congenital heart disease: the chicken and egg problem.

    abstract::Inborn cardiac diseases are among the most frequent congenital anomalies and are the main cause of death in infants within the first year of age in industrialized countries when not adequately treated. They can be divided into simple and complex cardiac malformations. The former ones, for instance atrial and ventricul...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Salameh A,Blanke K,Daehnert I

    更新日期:2013-06-03 00:00:00

  • ORY-1001 Suppresses Cell Growth and Induces Apoptosis in Lung Cancer Through Triggering HK2 Mediated Warburg Effect.

    abstract::ORY-1001, an inhibitor of covalent lysine (K)-specific demethylase 1A (KDM1A), has been used as a therapy for the treatment of acute leukemia. However, the underlying mechanisms of anticancer are still not fully elucidated. Here, we report that KDM1A is highly expressed in lung cancers, where it appears to drive aggre...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Lu Z,Guo Y,Zhang X,Li J,Li L,Zhang S,Shan C

    更新日期:2018-12-04 00:00:00

  • Physiological implications of NTBI uptake by T lymphocytes.

    abstract::In iron overload disorders a significant fraction of the total iron circulates in the plasma as low molecular weight complexes not bound to transferrin, known as non-transferrin-bound iron (NTBI). By catalyzing the formation of free radicals, NTBI accumulation results in oxidative stress and cellular damage, being a m...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Pinto JP,Arezes J,Dias V,Oliveira S,Vieira I,Costa M,Vos M,Carlsson A,Rikers Y,Rangel M,Porto G

    更新日期:2014-02-26 00:00:00

  • 1α,25(OH)2D3 Radiosensitizes Cancer Cells by Activating the NADPH/ROS Pathway.

    abstract::The radioresistance of tumors affect the outcome of radiotherapy. Accumulating data suggest that 1α,25(OH)2D3 is a potential anti-oncogenic molecule in various cancers. In the present study, we investigated the radiosensitive effects and underlying mechanisms of 1α,25(OH)2D3in vitro and in vivo. We found that 1α,25(OH...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Ji MT,Nie J,Nie XF,Hu WT,Pei HL,Wan JM,Wang AQ,Zhou GM,Zhang ZL,Chang L,Li BY

    更新日期:2020-08-07 00:00:00

  • Recombinant Human Endostatin Suppresses Mouse Osteoclast Formation by Inhibiting the NF-κB and MAPKs Signaling Pathways.

    abstract::Rheumatoid arthritis is an autoimmune disease characterized by synovial hyperplasia and progressive joint destruction. As reported previously, recombinant human endostatin (rhEndostatin) is associated with inhibition of joint bone destruction present in rat adjuvant-induced arthritis; however, the effect of rhEndostat...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Chen N,Gao RF,Yuan FL,Zhao MD

    更新日期:2016-06-01 00:00:00

  • Mechanistic Study of Bakuchiol-Induced Anti-breast Cancer Stem Cell and in Vivo Anti-metastasis Effects.

    abstract::Cancer stem cells are involved in cancer establishment, progression, and resistance to current treatments. We demonstrated the in vitro and in vivo anti-breast cancer effect of bakuchiol in a previous study. However, the ability of bakuchiol to target breast cancer stem cells (BCSCs) and inhibit breast cancer metastas...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Li L,Liu CC,Chen X,Xu S,Hernandez Cortes-Manno S,Cheng SH

    更新日期:2017-10-18 00:00:00

  • Visceral Fat Dysfunctions in the Rat Social Isolation Model of Psychosis.

    abstract::Medication with neuroleptics has been associated with adipose tissue dysfunctions and, in particular, with increased visceral fat amount. However, several studies suggested that antipsychotic treatment might not be the main responsible of fat mass accumulation, as this has been also described in not treated psychotic ...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Schiavone S,Camerino GM,Mhillaj E,Zotti M,Colaianna M,De Giorgi A,Trotta A,Cantatore FP,Conte E,Bove M,Tucci P,Morgese MG,Trabace L

    更新日期:2017-11-08 00:00:00

  • Metabolomics Coupled with Multivariate Data and Pathway Analysis on Potential Biomarkers in Cholestasis and Intervention Effect of Paeonia lactiflora Pall.

    abstract:BACKGROUND:The dried root of Paeonia lactiflora Pall. (PLP) is a classical Chinese herbal medicine that has been used to treat hepatic disease for 1000s of years. Our previous work suggested that PLP can be used to treat hepatitis with severe cholestasis. This study explored the mechanism by which PLP affects ANIT-indu...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Ma X,Chi YH,Niu M,Zhu Y,Zhao YL,Chen Z,Wang JB,Zhang CE,Li JY,Wang LF,Gong M,Wei SZ,Chen C,Zhang L,Wu MQ,Xiao XH

    更新日期:2016-02-04 00:00:00

  • Suppression of mICAT in Mouse Small Intestinal Myocytes by General Anaesthetic Ketamine and its Recovery by TRPC4 Agonist (-)-englerin A.

    abstract::A better understanding of the negative impact of general anesthetics on gastrointestinal motility requires thorough knowledge of their molecular targets. In this respect the muscarinic cationic current (mICAT carried mainly via TRPC4 channels) that initiates cholinergic excitation-contraction coupling in the gut is of...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Melnyk MI,Dryn DO,Al Kury LT,Dziuba DO,Zholos AV

    更新日期:2020-12-18 00:00:00

  • Shexiang Baoxin Pill, a Formulated Chinese Herbal Mixture, Induces Neuronal Differentiation of PC12 Cells: A Signaling Triggered by Activation of Protein Kinase A.

    abstract::Background: Shexiang Baoxin Pill (SBP) is a well-known composite formula of traditional Chinese medicine (TCM), which is commonly used today in treating cardiovascular diseases. SBP consists of seven materials thereof, including Moschus, extract of Ginseng Radix et Rhizoma, Bovis Calculus Artifactus, Cinnamomi Cortex,...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Xu ML,Zheng ZY,Xia YJ,Liu EY,Chan SK,Hu WH,Duan R,Dong TT,Zhan CS,Shang XH,Tsim KW

    更新日期:2019-10-09 00:00:00

  • DT-13 Inhibits Proliferation and Metastasis of Human Prostate Cancer Cells Through Blocking PI3K/Akt Pathway.

    abstract::DT-13, a saponin monomer 13 from the dwarf lilyturf tuber, was reported to exhibit anti-inflammatory, hepatoprotective, cardioprotective as well as antitumor activities in a number of tumor cells. Prostate cancer is the second leading cause of cancer death in males, discovery of novel antitumor drug for therapy of pro...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Wang Z,Wang Y,Zhu S,Liu Y,Peng X,Zhang S,Zhang Z,Qiu Y,Jin M,Wang R,Zhong Y,Kong D

    更新日期:2018-12-07 00:00:00

  • Short-Term Efficacy and Tolerability of Paroxetine Versus Placebo for Panic Disorder: A Meta-Analysis of Randomized Controlled Trials.

    abstract:Objective:To explore the short-term efficacy and tolerability of paroxetine in the treatment of panic disorder in adults. Methods:Multiple electronic databases were searched to find randomized controlled trials (RCTs) on paroxetine and panic disorder. The primary efficacy outcomes were: the mean change compared to the...

    journal_title:Frontiers in pharmacology



    authors: Zhang B,Wang C,Cui L,Gao J,Wang C,Tan X,Fang S

    更新日期:2020-03-31 00:00:00

  • Use of Oral Corticosteroids and Risk of Hip Fracture in the Elderly in a Case-Control Study.

    abstract::Aim: Little is known regarding the relationship between use of oral corticosteroids and hip fracture in the elderly in Taiwan. The aim of the study was to examine this issue. Methods: A retrospective population-based case-control study using the database of the Taiwan National Health Insurance Program (2000-2013) was ...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Lai SW,Lin CL,Liao KF

    更新日期:2017-09-11 00:00:00

  • Molecular Mechanisms of T Cells Activation by Dendritic Cells in Autoimmune Diseases.

    abstract::The interaction between T cell and dendritic cells (DCs) that leads to T cell activation affects the progression of the immune response including autoimmune diseases. Antigen presentation on immune cell surface, formation of an immunological synapse (IS), and specific identification of complex by T cells including two...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章,评审


    authors: Tai Y,Wang Q,Korner H,Zhang L,Wei W

    更新日期:2018-06-26 00:00:00

  • Withanolide D Exhibits Similar Cytostatic Effect in Drug-Resistant and Drug-Sensitive Multiple Myeloma Cells.

    abstract::In spite of recent therapeutic advances, multiple myeloma (MM) remains a malignancy with very low curability. This has been partly attributed to the existence of a drug-resistant subpopulation known as cancer stem cells (CSCs). MM-CSCs are equipped with the necessary tools that render them highly resistant to virtuall...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Issa ME,Wijeratne EMK,Gunatilaka AAL,Cuendet M

    更新日期:2017-09-08 00:00:00

  • Pharmacotherapy of patients with mild persistent asthma: strategies and unresolved issues.

    abstract::In studies comparing regular versus on-demand treatment for patients with mild persistent asthma, on-demand treatment seems to have a similar efficacy on clinical and functional outcomes, but it does not suppress chronic airway inflammation or airway hyper-responsiveness (AHR) associated with asthma. Data on the effic...

    journal_title:Frontiers in pharmacology

    pub_type: 杂志文章


    authors: Montuschi P

    更新日期:2011-07-14 00:00:00