Desmopressin for treating nocturia in patients with multiple sclerosis: A systematic review: A report from the Neuro-Urology Promotion Committee of the International Continence Society (ICS).

Abstract

AIMS:

To systematically assess all available evidence on efficacy and safety of desmopressin for treating nocturia in patients with multiple sclerosis (MS).

METHODS:

This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were identified by electronic search of Cochrane register, Embase, Medline, Scopus (last search March 3, 2018) and by screening of reference lists and reviews.

RESULTS:

After screening of 7015 abstracts, 8 prospective, and 1 retrospective studies were included enrolling a total of 178 patients. The mean patient age ranged between 43 and 51 years. A significant decrease in the number of micturitions per night was reported in 5 studies. An increase in the maximum hours of uninterrupted sleep was only found in two studies. A significant reduction of the volume of nocturnal incontinence was described in one study. The patient satisfaction rates ranged from 56% to 82%. The rate of adverse events was between 0% and 57.9%. The rate of hyponatremia ranged from 0% to 23.5% and other commonly reported adverse events were headache, nausea, fluid retention, rhinitis/epistaxis, malaise, and swollen ankles. Risk of bias and confounding was relevant in all studies.

CONCLUSIONS:

Preliminary data suggest that desmopressin might be effective for treating nocturia in patients with MS. However, adverse events are relatively common, the overall quality of evidence is low and the number of studied patients is very limited. Further studies with newer formulations of desmopressin are highly warranted.

• Authors: Véronique Phé, Marc P Schneider, Benoit Peyronnet, Nadim Abo Youssef, Livio Mordasini, Emmanuel Chartier-Kastler, Lucas M Bachmann, Thomas M Kessler
• Journal: Neurourology and urodynamics (Neurourol Urodyn) Vol. 38 Issue 2 Pg. 563-571 (02 2019) ISSN: 1520-6777 [Electronic] United States
• PMID: 30653737 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Systematic Review)
• Copyright: © 2019 Wiley Periodicals, Inc.

Chemical References

• Antidiuretic Agents
• Deamino Arginine Vasopressin

Topics

• Antidiuretic Agents (therapeutic use)
• Deamino Arginine Vasopressin (therapeutic use)
• Humans
• Multiple Sclerosis (complications)
• Nocturia (complications, drug therapy)
• Treatment Outcome