To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Combining an Anticholinergic With Desmopressin Enhances Treatment of Asymptomatic Nocturnal Enuresis: Presented at AAP URL: http://www.pslgroup.com/dg/21655E.htm Doctor's Guide October 29, 2007
By Nora Steiner Mealy SAN FRANCISCO, CA -- October 29, 2007 -- Children with nocturnal enuresis that did not respond to desmopressin alone can have dry nights when an anticholinergic medication is added to their desmopressin, researchers reported here at the American Academy of Pediatrics 2007 National Conference and Exhibition (AAP). The study findings were presented by Paul F. Austin, MD, Assistant Professor, Division of Urologic Surgery, and Director of Pediatric Urology Research, Washington University, St. Louis Children's Hospital, St. Louis, Missouri, United States. Dr. Austin and colleagues enrolled 41 patients with nocturnal enuresis who had less than a 50% improvement to the maximum dosage of desmopressin. Patients were randomised in a double-blind fashion to either an extended-release anticholinergic or placebo, both administered in combination with desmopressin. Children with bowel or bladder dysfunction were excluded from the study. Both treatment groups were equally matched for age, gender, functional bladder capacity, and number of wet nights per week. Patients were reassessed after 1 month of therapy with voiding and elimination diaries. Seven patients were excluded for noncompliance with treatment The risk of wet episodes per night over 7 days was calculated for each treatment group, adjusting for pretreatment propensity of wet episodes and age, using a generalised estimating equation approach. After 1 month of treatment, the anticholinergic group had a statistically significantly reduced risk of a wet episode of 66% (odds ratio, 0.33) compared with the placebo group. Although desmopressin is standard medical therapy for primary monosymptomatic nocturnal enuresis, many physicians already use additional anticholinergic therapy for patients who do not respond to monotherapy, Dr. Austin said. Anticholinergic therapy is an acceptable treatment for children with overactive bladder or lower urinary tract symptoms, he explained, and speculated that it may work by improving functional bladder capacity, or latent or occult nocturnal detrussor overactivity. "Combination desmopressin and anticholinergic treatment for primary monosymptomatic nocturnal enuresis has never before been validated with a placebo-controlled trial," Dr. Austin said. He noted that the "placebo effect" was evident in this trial, but the anticholinergic group still had a significantly better response. "These results underscore the need to perform placebo-controlled trials when trying to show treatment efficacy," he added. [Presentation title: Combination Therapy in Nonresponders to Desmopressin for Monosymptomatic Nocturnal Enuresis: A Randomized, Double-Blind, Placebo-Controlled Trial. Abstract 188] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.