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Long-term desmopressin response in primary nocturnal enuresis: open-label, multinational study

Lottmann, H.; Baydala, L.; Eggert, P.; Klein, B. M.; Evans, J. and Norgaard, Jens Peter LU (2009) In International Journal of Clinical Practice 63(1). p.35-45
Abstract
Primary nocturnal enuresis (PNE) is a distressing condition, particularly in severe cases (>= 3 wet nights/week). A prevalent pathophysiological mechanism, especially in monosymptomatic PNE (PMNE), is commonly believed to be an insufficient increase in night-time release of antidiuretic hormone. Desmopressin, a synthetic analogue of antidiuretic hormone, has been shown to reduce the number of wet nights experienced by PMNE patients in several controlled trials. This study was performed to evaluate desmopressin treatment in the real-life clinical setting and was a large-scale, 6-month investigation of efficacy and safety in patients with severe PNE. Predictive factors for desmopressin response were also evaluated. A total of 744 children... (More)
Primary nocturnal enuresis (PNE) is a distressing condition, particularly in severe cases (>= 3 wet nights/week). A prevalent pathophysiological mechanism, especially in monosymptomatic PNE (PMNE), is commonly believed to be an insufficient increase in night-time release of antidiuretic hormone. Desmopressin, a synthetic analogue of antidiuretic hormone, has been shown to reduce the number of wet nights experienced by PMNE patients in several controlled trials. This study was performed to evaluate desmopressin treatment in the real-life clinical setting and was a large-scale, 6-month investigation of efficacy and safety in patients with severe PNE. Predictive factors for desmopressin response were also evaluated. A total of 744 children aged 5 years and above from four countries were involved in the study. At baseline, patients had a median of 6 wet nights/week; at 6 months, 41% of patients had experienced >= 50% reduction in the mean number of wet nights. Long-term desmopressin treatment was consistently well-tolerated across all ages, with 5% of patients experiencing any treatment-related adverse events. The strength of treatment response was associated with nocturnal diuresis (p < 0.0001) and age (p = 0.0167) in logistic regression analyses. Compliance and dosage were also associated with response and more patients experienced >= 50% reduction in wet nights after 6 months' treatment than earlier in the study, suggesting the value of persistent treatment. This study shows that long-term desmopressin treatment in the clinical setting is effective and well-tolerated in PNE patients of 5 years and upwards. Early improvements in bedwetting of any appreciable magnitude may be rewarding, may facilitate compliance and enable good long-term response. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Journal of Clinical Practice
volume
63
issue
1
pages
35 - 45
publisher
Wiley-Blackwell
external identifiers
  • wos:000261713300008
  • scopus:57649225146
ISSN
1742-1241
DOI
10.1111/j.1742-1241.2008.01956.x
language
English
LU publication?
yes
id
a02ae3d1-b37c-4934-8e82-65c9c016afc6 (old id 1313755)
date added to LUP
2009-03-06 13:25:08
date last changed
2017-06-11 04:09:42
@article{a02ae3d1-b37c-4934-8e82-65c9c016afc6,
  abstract     = {Primary nocturnal enuresis (PNE) is a distressing condition, particularly in severe cases (&gt;= 3 wet nights/week). A prevalent pathophysiological mechanism, especially in monosymptomatic PNE (PMNE), is commonly believed to be an insufficient increase in night-time release of antidiuretic hormone. Desmopressin, a synthetic analogue of antidiuretic hormone, has been shown to reduce the number of wet nights experienced by PMNE patients in several controlled trials. This study was performed to evaluate desmopressin treatment in the real-life clinical setting and was a large-scale, 6-month investigation of efficacy and safety in patients with severe PNE. Predictive factors for desmopressin response were also evaluated. A total of 744 children aged 5 years and above from four countries were involved in the study. At baseline, patients had a median of 6 wet nights/week; at 6 months, 41% of patients had experienced &gt;= 50% reduction in the mean number of wet nights. Long-term desmopressin treatment was consistently well-tolerated across all ages, with 5% of patients experiencing any treatment-related adverse events. The strength of treatment response was associated with nocturnal diuresis (p &lt; 0.0001) and age (p = 0.0167) in logistic regression analyses. Compliance and dosage were also associated with response and more patients experienced &gt;= 50% reduction in wet nights after 6 months' treatment than earlier in the study, suggesting the value of persistent treatment. This study shows that long-term desmopressin treatment in the clinical setting is effective and well-tolerated in PNE patients of 5 years and upwards. Early improvements in bedwetting of any appreciable magnitude may be rewarding, may facilitate compliance and enable good long-term response.},
  author       = {Lottmann, H. and Baydala, L. and Eggert, P. and Klein, B. M. and Evans, J. and Norgaard, Jens Peter},
  issn         = {1742-1241},
  language     = {eng},
  number       = {1},
  pages        = {35--45},
  publisher    = {Wiley-Blackwell},
  series       = {International Journal of Clinical Practice},
  title        = {Long-term desmopressin response in primary nocturnal enuresis: open-label, multinational study},
  url          = {http://dx.doi.org/10.1111/j.1742-1241.2008.01956.x},
  volume       = {63},
  year         = {2009},
}