Oral desmopressin lyophilisate (MELT) for monosymptomatic enuresis: structured versus abrupt withdrawal.

Abstract

OBJECTIVE:

To investigate whether a structured withdrawal program from a sublingual formulation of fast-melting oral desmopressin lyophilisate (MELT) is superior to a sudden withdrawal from this formulation in the treatment of monosymptomatic nocturnal enuresis.

MATERIALS AND METHODS:

One hundred and three children presented to our pediatric nephrology outpatient clinic for bedwetting. Eighty-one children, aged between 5½ and 14 years (mean age 8.64 years), were treated with MELT at a dosage of 120 mcg a day. Responders were randomized to been withdrawn from therapy, after 3 months, abruptly or in a structured withdrawal program (60 mcg/day for 15 days and then 60 mcg every second evening for another 15 days). Main outcome parameter was relapse rate 1 month after the end of treatment. Relapse was defined as bedwetting occurring more than 2 nights per month after the 1-month treatment-free period.

RESULTS:

Relapse rate at 1 month after the end of treatment was 47.83% in the group on a structured program versus 45.83% in the abrupt termination group (p = 0.89).

CONCLUSION:

Our study suggests that a structured withdrawal program from MELT therapy doesn't offer advantages compared to an abrupt termination in children with monosymptomatic nocturnal enuresis.

• Authors: Pietro Ferrara, Valerio Romano, Ivana Cortina, Francesca Ianniello, Giovanna Carmela Fabrizio, Antonio Chiaretti
• Journal: Journal of pediatric urology (J Pediatr Urol) Vol. 10 Issue 1 Pg. 52-5 (Feb 2014) ISSN: 1873-4898 [Electronic] England
• PMID: 23791016 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Antidiuretic Agents
• Deamino Arginine Vasopressin

Topics

• Administration, Sublingual
• Adolescent
• Antidiuretic Agents (administration & dosage)
• Child
• Child, Preschool
• Deamino Arginine Vasopressin (administration & dosage)
• Enuresis (drug therapy)
• Female
• Humans
• Male
• Recurrence