Desmopressin 120 mcg, 180 mcg, 240 mcg: The right treatment for the right patient

Arch Ital Urol Androl. 2018 Jun 30;90(2):127-129. doi: 10.4081/aiua.2018.2.127.

Abstract

Background: The first-line drug therapy for patients with nocturnal enuresis (NE) associated with nocturnal polyuria and normal bladder function is desmopressin (dDAVP).

Objective: To evaluate if increasing dose of oral desmopressin lyophilisate (MELT) can improve response rates to dDAVP and is useful in enuretic children.

Materials and methods: We enrolled a total of 260 children all diagnosed with NE. Enuretic children were treated with increasing MELT at a dose of 120, 180 and 240 mcg a day.

Results: We included in our study a total of 237 children, 164 males (69.2%) and 73 females (30.8%) aged between 5 and 18 years (mean age 10.32 ± 2.52 years). Of the 237 patients enrolled in the study and treated with MELT 120 mcg, a full response was achieved in 135 (56.9%). A partial response was achieved in 21 (8.9%) patients, therefore the dose was increased up to 180 mcg, with further improving symptoms (14.3%) or full response (9.5%), and up to 240 mcg, without usefulness.

Conclusions: MELT at the dose of 120 mcg resulted efficacy and safety; the increased dose up to 180 mcg resulted poorly efficacy; finally, the further increase up to 240 mcg did not improve the symptoms with the increased risk of side effects.

Keywords: Desmopressin; Nocturnal enuresis.

MeSH terms

  • Administration, Oral
  • Adolescent
  • Child
  • Child, Preschool
  • Deamino Arginine Vasopressin / administration & dosage*
  • Deamino Arginine Vasopressin / adverse effects
  • Deamino Arginine Vasopressin / therapeutic use*
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Male
  • Nocturnal Enuresis / drug therapy*
  • Renal Agents / administration & dosage*
  • Renal Agents / adverse effects
  • Renal Agents / therapeutic use*
  • Treatment Outcome

Substances

  • Renal Agents
  • Deamino Arginine Vasopressin