DESMOPRESSIN (DDAVP, DESMOTABS, DESMOSPRAY, DESMOMELT)

Ferring has a long standing interest in the area of Urology, beginning with the development of the drug Desmopressin (desmopressin acetate) in the mid-1970s. The company continues to research and develop new products for the treatment of urological disorders.

Desmopressin is a synthetic analogue of vasopressin with an anti-diuretic effect on urine production.

DDAVP, DESMOSPRAY, DESMOTABS and DESMOMELT(desmopressin) are products with a long history for Ferring. Originally desmopressin was developed for the treatment of diabetes insipidus, a disease characterised by the production of large amounts of urine. Desmopressin is still used in this rare disease and can also be used to treat Nocturia associated with Multiple Sclerosis. DESMOTABS and new DESMOMELT (a formulation of desmopressin suitable for children which melts rapidly under the tongue) can be used to treat primary nocturnal enuresis (PNE), or bedwetting, in some children. This is a disorder that causes significant distress for many children and their families (7).

PRIMARY NOCTURNAL ENURESIS (BEDWETTING)

Prevalence:
Primary Nocturnal Enuresis (PNE) is a far more common problem than many parents believe(1). Most children are able to remain dry at night by the time they reach five years old(2) however if left untreated it can persist so that even at 7.5 years 16 out of every hundred children wet the bed(3). This means that in a class of 30 pupils 4 or 5 of them could be affected. It is generally more common in boys than in girls(3).

The severity of the bedwetting varies for children 7.5 years of age (3):

  • 12 children in every hundred wets less than once a week
  • 1 child in every hundred wets once per week
  • 3 children in every hundred wets twice or more per week

Persistent bedwetting is very upsetting:
If a child regularly wets the bed then they may well experience feelings of shame and embarrassment (4). The child is often terrified that if their friends find out they will be subjected to teasing or bullying. Children who wet the bed can become withdrawn and avoid situations where their condition might be found out, such as overnight trips (1). PNE can also cause stress to the parents who are faced with having their sleep disturbed and the extra laundry of bedlinen and nightclothes.

Five Facts you probably didn't know about bedwetting:

  1. Bedwetting may be hereditary - about 5 out of 10 children who wet the bed have a brother, sister or parent who had trouble staying dry at night (8)
     
  2. 16% of all seven year olds regularly wet the bed (3)
     
  3. Twice as many boys under the age of thirteen wet the bed than girls (3)
     
  4. One third of parents attribute bedwetting to laziness (1)
     
  5. Bedwetting can be treated with a prescription medicine

What causes bedwetting:
Contrary to popular opinion bedwetting is not usually the result of a psychological problem (4). If a child over the age of 5 wets the bed and has never sustained a dry period for six months or more, then the cause is most likely to be a medical condition called primary nocturnal enuresis (PNE), and the child may benefit from having their condition assessed by a doctor. If a child only very occasionally wets the bed, and has been dry for at least six months in the past then the cause may sometimes be anxiety or stressful events (12).

Getting help:
Despite the obvious extra laundry the condition entails (5) and the potential damage to the child 's self-esteem (6), a recent study suggets only 30% of patents have ever consulted a healthcare worker about their child's bedwetting (3). A child wetting the bed should be offered sympathy and reassured that they are not at fault. Punishing the child may be a counterproductive approach and could exacerbate the problem. Parents should be encouraged to talk about bedwetting with their doctor who will be able to give advice on it's possible causes and potential treatments.

Useful Links:

http://www.urinecontrol.co.uk/ (access available to doctors / healthcare professionals only)

http://www.eric.org.uk/ (Enuresis Resource and Information Centre)

http://www.stopbedwetting.org/ (patient website)

The children's National Service Framework can be accessed via the following site:
http://www.doh.gov.uk/

Please refer to the links page for a full list.

CRANIAL DIABETES INSIPIDUS (CDI)

Background:
Cranial diabetes insipidus is a disorder in which the kidneys are unable to concentrate urine because of a lack of Vasopressin (antidiuretic hormone). This results in the production of large volumes of urine and a feeling of intense thirst. It is caused by a deficiency or absence of vasopressin secretion from the posterior pituitary gland.

Symptoms include thirst and the need to pass urine very frequently during the day and night. Cranial diabetes insipidus can be acquired through physical damage to the posterior pituitary gland (eg. surgery or head injury), or by disease (e.g. brain tumour). It can also be inherited as a genetic defect, or it can be idiopathic (thought to be due to an autoimmune process).

Prevalence:
CDI can occur at any age. It is a rare disorder affecting only about 1in 25,000 people (Pituitary Foundation).

Getting Help:
Your GP is the best person to contact if you feel you have these symptoms. They may then refer you to hospital oupatients where tests will be carried out to determine if you have CDI.

For further information please visit the Pituitary Foundation website at:

http://www.pituitary.org.uk/

NOCTURIA ASSOCIATED WITH MULTIPLE SCLEROSIS

Once multiple sclerosis (MS) is diagnosed, people often recognise that they have had the condition for many years. The cause is unknown, but it is thought that genetic and environmental factors play a role. The disease process is one of episodes where matter within the brain or spinal cord becomes damaged by the person’s own immune system. Many episodes do not cause any symptoms. There is no great impact on life expectancy.

Bladder symptoms are common in people with MS. Bladder dysfunction can be very disabling and may have many adverse consequences including causing emotional distress, disturbing sleep and curtailing social activities. Matters are worsened by people not wanting to discuss their problems.

Treatments are available to help with many of the symptoms of MS. The patient should be encouraged to talk to the doctor about their symptoms. For further advice the following patient organisation can help:

http://www.mssociety.org.uk/


GONAPEPTYL

GONAPEPTYL (triptorelin) contains the GnRH agonist, triptorelin, and is used in the treatment of a number of hormone dependent conditions such as central precocious puberty in children and prostate cancer in men.

GONAPEPTYL works by blocking the natural production of sex hormones, thereby slowing the onset of precocious puberty in children or the development of prostate cancer in men.
 

PATIENT INFORMATION LEAFLETS & SUMMARY OF PRODUCT CHARACTERISTICS

Please visit the document page.

CONTACT DETAILS

Contact the Urology Department by email at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or by telephone on +44 (0) 1753 214800.

REFERENCES

1. BRMB International questioned 1,000 people 15-17 February 2002
2. Forsythe & Butler, 1989 - Archives of Disease in Childhood, 1989, 64, 879-885
3. Alspac, Butler et al 2005, BJU; 96: 404-410
4. Hjalmas 1997 Acta Paediatra 86 : 919-922 1997
5. Norgard JP et al, Scand J Urol Nephrol 1994 ; 163 : 49-54
6. Hagglof B et al Eur Urol 1998;33 (suppl 3):16-19
7. Lackgren G et al Acta Paediatr 88: 679-90. 1999
8. Bakwin H Amer J Dis Child/Vol 121, March 1971
9. Sadovnick A Ann Neurol 1994;36(S2):S197-S203
10. Fowler, CJ Int MSl Vol 1 No 3
11. Alspac, Butler et al 2005 Child: Care, Health & Development 31 6 659-667
12. Hjalmas The Journal of Urology Vol 17 2545-2561, June 2004

 
 
      Site Map    Legal Disclaimer    Search    © Ferring 2009