Efficacy and safety of first-line therapies and first-line-based combination therapies for monosymptomatic nocturnal enuresis in children: a network meta-analysis.
Objective: To systematically evaluate the efficacy and safety of first-line therapies and first-line-based combination therapies for treating monosymptomatic nocturnal enuresis (MNE) in children using a network meta-analysis. Methods: PubMed, Embase, the Cochrane Library, Scopus, Web of Science, and...
| Publicado en: | Pediatric Nephrology Vol. 41; no. 10; pp. 3333 - 3347 |
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| Autores principales: | , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Springer Nature
Oct2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=196240280&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 196240280 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Oct2026 vid: 41 iid: 10 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 196240280 192536483 196240280 196240280 10.1007/s00467-026-07265-y 196240280 ppf: 3333 ppct: 14 formats: tig: atl: Efficacy and safety of first-line therapies and first-line-based combination therapies for monosymptomatic nocturnal enuresis in children: a network meta-analysis. aug: au: Chen, Xi Zeng, Fang Tian, Niannian Wang, Bingbing affil: https://ror.org/01dr2b756 Department of Pediatrics, Xiangyang No.1 People's Hospital, Hubei University of Medicine, 441000, Xiangyang, China sug: subj: Enuresis, Nocturnal Symptoms Enuresis, Nocturnal Drug Therapy Drug Efficacy Evaluation Patient Safety Evaluation Renal Agents Therapeutic Use Drug Therapy, Combination Human Meta Analysis Systematic Review PubMed Embase Cochrane Library Data Analysis Software Male Female Child Desmopressin Oxybutynin Heterocyclic Compounds Tolterodine Pathologic Complete Response Child: 6-12 years Male Female ab: Objective: To systematically evaluate the efficacy and safety of first-line therapies and first-line-based combination therapies for treating monosymptomatic nocturnal enuresis (MNE) in children using a network meta-analysis. Methods: PubMed, Embase, the Cochrane Library, Scopus, Web of Science, and ClinicalTrials.gov were comprehensively searched to identify randomized controlled trials (RCTs) comparing either different first-line therapies or combination regimens involving first-line treatments versus monotherapy for MNE. Two researchers independently screened studies, extracted data according to predefined criteria, and assessed the methodological quality of the included trials. Data were analyzed using R software, with relative risk (RR) used as the effect size for dichotomous outcomes. The certainty of evidence was assessed using the Confidence in Network Meta-Analysis (CINeMA) approach. Results: A total of 23 RCTs involving 2424 children and eight interventions were included. The network meta-analysis showed that desmopressin combined with oxybutynin, propiverine, solifenacin, or tolterodine was significantly more effective in achieving complete response (CR) than desmopressin monotherapy. Additionally, combinations of desmopressin with oxybutynin or tolterodine were superior to alarm monotherapy. No statistically significant differences were found among interventions regarding partial response (PR). For relapse rate, alarm monotherapy, desmopressin plus alarm, and desmopressin plus solifenacin were significantly better than desmopressin monotherapy. No significant differences in adverse events (AEs) were found across the interventions. In terms of CR, the top three interventions were desmopressin plus oxybutynin, desmopressin plus tolterodine, and desmopressin plus solifenacin. For PR, the leading treatments were desmopressin plus oxybutynin, desmopressin monotherapy, and alarm therapy. Regarding relapse rate, desmopressin plus solifenacin, alarm therapy, and desmopressin plus tolterodine ranked highest. For AEs, alarm therapy, desmopressin plus propiverine, and desmopressin monotherapy had the lowest incidence. The certainty of evidence for the primary outcome ranged from moderate to low according to the CINeMA assessment. Conclusion: Desmopressin combined with anticholinergic agents significantly improved CR versus desmopressin monotherapy and demonstrated partial significant superiority over alarm therapy alone. Among these, desmopressin plus oxybutynin demonstrated the best overall efficacy. Alarm therapy and desmopressin alone showed similar therapeutic effectiveness. Desmopressin monotherapy was associated with a higher relapse rate. Importantly, combination therapy did not significantly increase the risk of AEs compared to monotherapies. According to the CINeMA framework, the certainty of evidence was mostly low to moderate, highlighting the need for cautious interpretation and further high-quality trials. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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