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SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Renal Pharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1517979
The efficacy and safety of mirabegron and α-adrenergic receptor antagonist in the treatment of distal ureteral stones: a systematic review and meta-analysis
Provisionally accepted
Guo Yicheng 1,2
Fengze Sun 1,2
Yini Wang 1,3
Yanfei Li 1,2
Tianqi Wang 1,2 Xiaohong Ma 1,2*
Jitao Wu 1,2*- 1 Department of Urology, Yantai Yuhuangding Hospital, Yantai, China
- 2 Qingdao University, Qingdao, Shandong Province, China
- 3 Binzhou Medical University, Binzhou, Shandong Province, China
Introduction: To systematically evaluate the efficacy and safety of mirabegron compared to α-adrenergic receptor antagonists for treating distal ureteral stones.Methods: A comprehensive search of EMBASE, PubMed, and Cochrane databases was conducted to identify studies comparing mirabegron and α-adrenergic receptor antagonists for stone expulsion. The primary outcome was stone expulsion rate (SER), and secondary outcomes included stone expulsion interval (SEI) and pain episode frequency. Risk ratio (RR) and mean differences (MD) with 95% CIs were calculated.Results: Six studies involving 487 participants were included. There was no significant difference in SER between mirabegron and α-adrenergic receptor antagonists (RR = 1.06; 95% CI = 0.93-1.22; P = 0.34). SEI showed no significant difference either (MD = 0.05; 95% CI = -3.23 to 3.34; P = 0.58). However, pain episodes were significantly reduced in the mirabegron group (MD = -0.36; 95% CI = -0.63 to -0.09; P = 0.01). Subgroup analysis showed reduced pain episodes with mirabegron versus silodosin but not tamsulosin. Mirabegron also had fewer side effects like headache (RR = 0.34; 95% CI = 0.13-0.87; P = 0.02) and orthostatic hypotension (RR = 0.11; 95% CI = 0.02-0.55; P = 0.008), while dizziness and ejaculation dysfunction rates were comparable.Conclusion: Mirabegron reduced pain episodes during treatment for distal ureteral stones, particularly when compared to silodosin, despite no significant differences in SER or SEI. Its favorable safety profile suggests potential as a therapeutic option. Further randomized controlled trials are needed to confirm these findings.
Keywords: Mirabegron, Ureteral stone, α-adrenergic receptor antagonist, Meta-analysis, β3adrenergic receptor mirabegron, β3adrenergic receptor
Received: 29 Oct 2024; Accepted: 07 Mar 2025.
Copyright: © 2025 Yicheng, Sun, Wang, Li, Wang, Ma and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiaohong Ma, Department of Urology, Yantai Yuhuangding Hospital, Yantai, China
Jitao Wu, Department of Urology, Yantai Yuhuangding Hospital, Yantai, China
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