Efficacy and safety of first-line therapies and first-line-based combination therapies for monosymptomatic nocturnal enuresis in children: a network meta-analysis
Abstract
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…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,424 participants or records.
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