Institutional Research Office, Asahikawa Medical University, Asahikawa, Japan.
Center for Advanced Research and Education, Asahikawa Medical University, 2-1-1-1, Midorigaoka-Higashi, Asahikawa, Hokkaido, 078-8510, Japan.
World J Urol. 2021 Sep;39(9):3517-3524. doi: 10.1007/s00345-021-03664-y. Epub 2021 Mar 22.
We analyzed the annual trends in and initial choice of pharmacotherapy for children with nocturnal enuresis (NE) using a large-scale medical claims database in Japan.
A retrospective descriptive study performed using data from the Japan Medical Data Center between January 2005 and March 2019 involving 23,814 registrants under 16 years of age. In the first cohort of children with NE, we analyzed the comorbidities and associated annual pharmacotherapy prescribing trends. In the second cohort of only newly diagnosed cases, we analyzed the first prescribed age and initial choice of pharmacotherapy.
A total of 3494 children with NE were identified (mean age, 5.1 ± 3.6 years; male, 66.0%). An incremental increase in the proportion of children administered NE medications was observed. The proportion of children treated with desmopressin significantly increased, whereas the prescription of tricyclic antidepressants significantly decreased and that of anticholinergics did not significantly change. Among the newly diagnosed children, 1897 were treated with approximately 90% of the prescribed monotherapy. Sublingual desmopressin monotherapy accounts for more than half of the initial pharmacotherapy from 2016 onward. Regardless of the drug class, pharmacological therapy was commonly initiated at the age of 8.3 ± 2.1 years.
In Japan, the proportion of children treated with pharmacotherapy has been increasing. Furthermore, since the introduction of desmopressin sublingual formulations in 2012, a paradigm shift has occurred and this form of medication is now the most commonly prescribed, both from the annual perspective and as an initial choice among the newly diagnosed.
我们利用日本大规模医疗索赔数据库分析了儿童遗尿症（NE）患者的年度药物治疗趋势和初始选择。
这是一项回顾性描述性研究，使用日本医疗数据中心 2005 年 1 月至 2019 年 3 月期间的数据，涉及 23814 名 16 岁以下的登记患者。在第一个有 NE 的儿童队列中，我们分析了合并症和相关的年度药物治疗处方趋势。在仅新诊断病例的第二个队列中，我们分析了首次规定的年龄和初始药物治疗选择。
共确定了 3494 例 NE 患儿（平均年龄为 5.1±3.6 岁；男性占 66.0%）。接受 NE 药物治疗的儿童比例呈递增趋势。去氨加压素的使用比例显著增加，三环类抗抑郁药的处方显著减少，而抗胆碱能药物的处方没有显著变化。在新诊断的儿童中，1897 例接受了大约 90%的单药治疗。自 2016 年以来，舌下含服去氨加压素单药治疗占初始药物治疗的一半以上。无论药物类别如何，药理学治疗通常在 8.3±2.1 岁开始。
在日本，接受药物治疗的儿童比例一直在增加。此外，自从 2012 年推出去氨加压素舌下制剂以来，已经发生了范式转变，这种形式的药物治疗现在是最常见的处方，无论是从年度角度还是从新诊断患者的初始选择角度来看都是如此。
