Effect of desmopressin lyophilisate (MELT) plus anticholinergics combination on functional bladder capacity and therapeutic outcome as the first-line treatment for primary monosymptomatic nocturnal enuresis: A randomized clinical trial.
Investig Clin Urol
; 62(3): 331-339, 2021 05.
Article
en En
| MEDLINE
| ID: mdl-33834643
ABSTRACT
PURPOSE:
To assess the efficacy of desmopressin plus anticholinergic combination therapy as first-line treatment for children with primary monosymptomatic nocturnal enuresis (PMNE) and to analyze this combination's effect on functional bladder capacity (FBC). MATERIALS ANDMETHODS:
A total of 99 children with PMNE were prospectively enrolled from 2015 to 2019 and randomly allocated to a monotherapy group (n=49), with oral desmopressin lyophilisate (MELT) only; and a combination group (n=50), with desmopressin plus an anticholinergic (propiverine 5 mg). Efficacy and FBC were evaluated at 1 and 3 months after treatment initiation; the relapse rate was assessed at 6 months after treatment cessation.RESULTS:
The combination therapy group showed a higher rate of complete response than the monotherapy group after 3 months of treatment (44.0% vs. 22.4%, p=0.002). A significant increase in mean FBC was observed only in the combination group, from 88.72±26.34 mL at baseline to 115.52±42.23 mL at 3 months of treatment (p=0.024). Combination therapy was significantly associated with treatment success at 3 months after treatment initiation (odds ratio [OR], 3.527; 95% confidence interval [CI], 1.203-6.983; p=0.011) and decreased risk of relapse at 6 months after treatment cessation (OR, 0.306; 95% CI, 0.213-0.894; p=0.021), by multivariable analysis.CONCLUSIONS:
This study represents the first prospective, randomized controlled trial showing higher response rates and lower relapse rates with desmopressin plus anticholinergic combination therapy compared with desmopressin monotherapy as first-line treatment for children with PMNE.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Bencilatos
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Antagonistas Muscarínicos
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Desamino Arginina Vasopresina
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Fármacos Antidiuréticos
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Enuresis Nocturna
Tipo de estudio:
Clinical_trials
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Observational_studies
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Risk_factors_studies
Límite:
Child
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Female
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Humans
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Male
Idioma:
En
Revista:
Investig Clin Urol
Año:
2021
Tipo del documento:
Article