Efficacy and safety of first-line therapies and first-line-based combination therapies for monosymptomatic nocturnal enuresis in children: a network meta-analysis - PubMed
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- #network meta-analysis
- #nocturnal enuresis
- #pediatric urology
- Network meta-analysis of 23 RCTs with 2424 children compared first-line therapies and their combinations for monosymptomatic nocturnal enuresis (MNE).
- Desmopressin combined with anticholinergics (oxybutynin, tolterodine, solifenacin, propiverine) showed significantly higher complete response (CR) rates than desmopressin monotherapy.
- Desmopressin plus oxybutynin or tolterodine was more effective than alarm monotherapy for CR, but no significant differences were found for partial response (PR).
- Alarm monotherapy, desmopressin plus alarm, and desmopressin plus solifenacin had lower relapse rates than desmopressin monotherapy.
- Adverse event rates did not differ significantly across interventions, with alarm therapy, desmopressin plus propiverine, and desmopressin monotherapy having the lowest incidence.
- Desmopressin plus oxybutynin ranked highest for CR and PR, while desmopressin plus solifenacin was top for relapse rate.
- Evidence certainty ranged from moderate to low per CINeMA, suggesting cautious interpretation and need for further high-quality trials.