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Desmopressin May Offer Better Convenience, Compliance Than Alarms for Paediatric Bedwetting: Presented at ICS

By Shazia Qureshi

ROTTERDAM, NETHERLANDS -- August 23, 2007 -- Desmopressin and an enuresis alarm were found to have similar efficacy in the treatment of primary nocturnal enuresis (PNE), but patients showed poorer compliance to the alarm treatment, researchers reported here at the 37th Annual Meeting of the International Continence Society (ICS).

Lead author Jonathan Evans, MD, Clinical Director, Family Health, Nottingham City Hospital, Nottingham, United Kingdom, also noted in his poster that among those patients being treated with the alarm, there was a high rate of early withdrawal from the study.

This was a phase 4 comparison study of oral desmopressin (0.2 or 0.4 mg) versus an enuresis alarm for the treatment of PNE in children. An enuresis alarm is a device that senses bedwetting while the user is asleep and sounds an alarm as a means of conditioning therapy for PNE.

A total of 192 patients were randomised to desmopressin treatment and 59 patients to the alarm for a treatment period of 6 months. The mean age was 8.3 years and 72% of the patients were male. At baseline, patients assigned to the desmopressin group experienced a mean of 5.59 wet nights per week while those assigned to the alarm treatment had 5.57 wet nights per week.

Dr. Evans reported that in the intention-to-treat analysis at 6 months, similar proportions of patients in both groups achieved at least a 50% reduction from baseline values in the number of wet nights per week (37.5% of desmopressin patients and 32.2% of alarm patients). Further analysis showed that desmopressin was not inferior to alarm treatment in achieving such a reduction in the number of wet nights.

However, 58% of the patients using alarm treatment withdrew from the study before it ended, as did 41% of patients taking desmopressin. Among those patients who stayed through the end of the study, compliance rates were consistently higher in the desmopressin group than in the alarm group. From baseline to 6 months, the mean nightly number of trips to the toilet increased in the alarm group and decreased in the desmopressin group.

The investigators noted that the sleep disruption caused by enuresis alarms may be a factor in the low compliance rates and high withdrawal rates seen in this study group. The authors also suggested that desmopressin, because it reduces of the number of voids per night, may be a more convenient option for patients with PNE.

The study was funded by Ferring Pharmaceuticals.


[Presentation title: "Desmopressin Response in the Treatment of Primary Nocturnal Enuresis in the United Kingdom" DRIP UK: an Open-Label, Randomised Comparative Study of Oral Desmopressin Versus Enuresis Alarm. Abstract 225]

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