Key Summary:
- Ureteral stone expulsion was significantly higher with Guang Jing by day 28.
- Stone passage occurred in 44.6% with Guang Jing versus 33.8% with placebo.
- Adverse event rates were similar between Guang Jing and placebo.
A RANDOMISED clinical trial has shown that Desmodium styracifolium total flavone capsules, known as Guang Jing Qian Cao, significantly increased ureteral stone expulsion by day 28, with a favourable safety profile.
There is currently no oral medication approved for the management of urolithiasis. Guang Jing has shown clinical benefits in previous studies, but researchers sought to confirm its effectiveness in a phase 3 randomised clinical trial.
The study was conducted at 34 sites across China from December 2017 to April 2020 and included 606 adults aged 18-70 years old who had been diagnosed with ureteral stones. The mean age was 43.0 years, and the mean stone size was 0.6 cm. Participants were randomised in a 3:1 ratio to receive either 0.6g of oral Guang Jing or placebo three times daily for 28 days. The primary outcome was stone passage rates (SPR) by day 28. Secondary outcomes included SPR by day 14, stone migration rate and stone migration distance. The Cochran–Mantel–Haenszel test and t tests were used for between-group comparisons for categorical and continuous outcomes, respectively.
Stone Passage Rates Improved with Guang Jing
Overall, the SPR was significantly higher for the group given Guang Jing than for the group given placebo, with 44.6% achieving stone passage by day 28 compared with 33.8% in the placebo group. This amounted to a relative risk of 1.32 (95% confidence interval [CI]: 1.03–1.69; p=0.03) and an absolute risk difference of 10.9 percentage points (95% CI: 2.0–19.7).
No significant differences in SPR by day 14 or stone migration distance were observed. By day 14, stone passage occurred in 29.1% of the Guang Jing group compared with 22.3% of the placebo group (p=0.14), while mean stone migration distance was 29.5 mm and 29.7 mm, respectively (p=0.11).
Importantly, adverse events were similar across both groups, with 19.3% of participants receiving Guang Jing and 18.2% receiving placebo experiencing an adverse event.
Potential Medical Expulsive Therapy Option
The findings suggest that Guang Jing could represent an additional medical expulsive therapy option for appropriately selected patients with urolithiasis, particularly those with 5–10 mm ureteral stones.
Although the study demonstrated a significant improvement in stone expulsion by day 28, it did not identify a significant difference in stone passage at day 14 or in stone migration distance. The researchers concluded that Guang Jing increased stone expulsion while maintaining a favourable safety profile.
Reference
Wang D et al. Desmodium styracifolium total flavone capsules for urolithiasis: a phase 3 randomized clinical trial. JAMA Netw Open. 2026;9;(9):e2632874.
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