ORAL DICLOFENAC IN THE PROPHYLACTIC TREATMENT OF RECURRENT RENAL COLIC - A DOUBLE-BLIND COMPARISON WITH PLACEBO

We have conducted a double-blind, randomized, placebo-controlled trial with oral diclofenac to study the prophylactic effect on renal colic recurrence and spontaneous stone expulsion rate. Forty-one patients we re given 50 mg oral diclofenac 3 times a day for 7 days after being di scharged for a colic episode from Oslo Emergency Hospital (<24 h stay) and 39 patients were given matching placebo tablets. The number of ne w renal colic episodes per accumulated patient treatment days was 64/2 87 in the diclofenac group and 119/273 in the placebo group (p < 0.01) . This difference was greatest during the first 4 treatment days. A si milar trend was found for pain intensity (0-10 cm VAS) with the greate st difference on day 1 (4.3 vs. 2.8, p = 0.05). Side effects, mainly g astrointestinal, were reported for 14% of the treatment days in both t reatment groups. Stone expulsion rate was almost identical (28 vs. 29 days), regardless of stone size. Readmission rate to Oslo Emergency Ho spital/other hospitals were 10 and 67% (p < 0.001). In conclusion, ora l treatment with diclofenac was effective as short-term prophylaxis of new colic episodes, especially during the first 4 days, and reduces t he number of hospital readmissions significantly. The stone passage ra te appears not to be affected.