To systematically assess all available evidence on efficacy and safety of desmopressin for treating nocturia in patients with multiple sclerosis (MS).
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.
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.
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.
Neurourology and urodynamics. 2019 Jan 17 [Epub]
Véronique Phé, Marc P Schneider, Benoit Peyronnet, Nadim Abo Youssef, Livio Mordasini, Emmanuel Chartier-Kastler, Lucas M Bachmann, Thomas M Kessler
Médecine Sorbonne Université, Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France., Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland., Department of Urology, Pontchaillou Hospital, Rennes, France., Department of Urology, Cantonal Hospital Lucerne, Lucerne, Switzerland., Medignition Inc., Research Consultants, Zürich, Switzerland.