Desmopressin use in pediatric nocturnal enuresis patients: is there a sex difference in prescription patterns?

Desmopressin is a long-established treatment for nocturnal enuresis with clear guidelines regarding its usage. A sex difference in renal sensitivity has recently been reported in adults. The objective of this study was to investigate real-life desmopressin prescription in the Danish pediatric population, and prescription patterns which may reflect a sex difference in pediatric usage. Formulation, dose, treatment duration, and safety (hyponatremia) were investigated. 40,596 children received 214,220 desmopressin prescriptions between 2004 and 2011 in the Danish National Prescription Registry. Data were linked to hyponatremia diagnoses from the National Patient Registry. Although the lowest recommended dose of desmopressin oral lyophilisate is 120 µg, around a fifth of children were prescribed 60 µg for long-term use. A greater proportion of girls (22.6%) than boys (19.8%) received this low dose. Treatment duration was longer for boys than girls on oral lyophilisate (mean 489-524 vs. 414-462 days) and tablet (0.1 mg: 204 vs. 161 days). Prescribed daily dose was consistent with time between prescriptions, indicating no significant drug holidays. There were no admissions for hyponatremia during the observation period. CONCLUSION: Danish national prescription data on pediatric desmopressin dosage are consistent with a greater sensitivity to desmopressin in girls than boys. Further studies are required. What is Known: • Desmopressin has been used for pediatric nocturnal enuresis for decades • Recent evidence suggests a sex difference in desmopressin sensitivity in adults What is New: • For the first time, desmopressin prescription practices in nocturnal enuresis are documented for an entire country • A higher proportion of girls than boys received a low dose of desmopressin, consistent with the sex difference in sensitivity reported in adults.

National Surveillance of Central Diabetes Insipidus (CDI) in Denmark: results from 5 years registration of 9309 prescriptions of desmopressin to 1285 CDI patients.

CONTEXT: Epidemiological data for central diabetes insipidus (CDI) are sparse. OBJECTIVE: The purpose of this study was to provide accurate epidemiological data on CDI on a national level. DESIGN AND SETTING: This was a drug utilization and patient registry study during a 5-year period from 2007 to 2011. METHODS: We used the Danish National Prescription Registry data linked with the Danish National Patient Registry to study the epidemiology of CDI using waiting time distribution and other pharmacoepidemiological methods. PATIENTS: A total of 1285 patients with CDI were recorded in the observation period and given 9309 prescriptions for desmopressin in the nasal formulation, orodispersible tablet, or conventional tablet. RESULTS: The period prevalence rate of CDI in Denmark over the 5-year period investigated was 23 CDI patients per 100 000 inhabitants, with a higher prevalence in children and older adults (>80 years of age). The 1-year period prevalence rate of CDI decreased in Denmark over the 5 years from approximately 10 to 7 CDI patients per 100 000 inhabitants. The yearly incidence rate of new cases of CDI was found to be 3 to 4 patients per 100 000. The incidence of (presumable) congenital CDI was found to be 2 infants per 100 000 infants. Half of the patients with CDI prescribed as oral treatment were provided dosing instructions to only administer the drug before bedtime, and one third of the CDI patients either had no specific instructions or were instructed to use the drug as needed. Hospital admissions due to severe hyponatremia occurred in 0.9% of patients over a 5-year period, predominantly in females with an incidence ratio of women to men of 1.8:1. CONCLUSION: Half of the cases of CDI are acquired later in life. At least half of the patients with CDI are instructed to prevent nocturnal polyuria, but it is not clear whether their CDI remains uncontrolled during the daytime or, alternatively, whether they use desmopressin only as needed. Female patients with CDI had approximately twice the number of hospital admissions due to severe hyponatremia than male patients with CDI.

[National surveillance of Helicobacter pylori eradication in Denmark. Results based on registration of 34.582 drug prescriptions]. / National overvågning af Helicobacter pylori-eradikationsterapi i Danmark. Resultater fra registreringen af 34.582 receptudskrivninger.

We wanted to characterize the use of H. pylori eradication therapy in Denmark (inhabitants 5,227,862). All H. pylori eradication treatments from a nation wide database covering all drug prescriptions in the period January 1994-June 1996 were identified. We found 28,784 out-patients having a prescription with drugs for H. pylori eradication, accounting for 34,582 prescriptions in total. The incidence of new consumers was 220 per 10(5) inhabitants per year, with a maximum at 70-79 years of age. Eighty-six percent of the patients had only one treatment course. Forty-five percent had an anti-ulcer drug prescribed 1-12 months after the H. pylori eradication therapy. Consumption of antibiotics used for H. pylori eradication accounted for 1.4% of the total consumption of antibiotics. In conclusion, the incidence of H. pylori eradication therapy was fairly stable but with changes in the pattern of drug regimens used. Anti-ulcer drugs were often given after H. pylori eradication therapy, suggesting an inappropriate use of eradication treatment.

National surveillance of Helicobacter pylori eradication therapy in Denmark. Results from registration of 34,582 prescriptions.

BACKGROUND: We wanted to characterize the use of Helicobacter pylori eradication therapy in Denmark (5,227,862 inhabitants). METHODS: All H. pylori eradication treatments from a nationwide database including all redeemed drug prescriptions in the period January 1994 to June 1996 were identified. So were all outpatients receiving a drug prescription for H. pylori eradication. RESULTS: We recorded 34,582 prescriptions for H. pylori eradication therapy given to 28,784 patients. The incidence of new consumers was 220 per 10(5) inhabitants per year, with a maximum at 70-79 years of age. Eighty-six per cent of the patients had only one treatment course. In 16% of the eradication therapies, nonsteroid anti-inflammatory drugs had been prescribed within the previous 3 months, and 45% had an anti-ulcer drug prescribed 1-12 months after the H. pylori eradication therapy. Consumption of antibiotics used for H. pylori eradication accounted for 1.4% of the total consumption of antibiotics. CONCLUSIONS: The incidence of H. pylori eradication therapy was fairly stable but with changes in the pattern of drug regimens used. Anti-ulcer drugs were often given after H. pylori eradication therapy, suggesting an inappropriate use of treatment.

[Utilization of calcium, vitamin D and diphosphonates used in the treatment of osteoporosis in Denmark 1994-1996. An epidemiological analysis of nationwide prescription data]. / Forbrug af calcium, vitamin D og bisfosfonater anvendt til behandling af manifest osteoporose i Danmark 1994-1996. En epidemiologisk analyse af landsdeekkende receptdata.

The aim of this study was to explore the utilization of calcium, vitamin D and bishosphonates used in treatment of osteoporosis. The data derive from the Register of Drug Statistics at the Danish Medicines Agency. The analysis encompassed 112,300 prescriptions presented by 25,692 patients during a period from 1 January 1994 to 30 June 1996. The consumption of calcium decreased, while the consumption of bisphosphonates increased 971% during the period. The one-year prevalence of use of calcium, vitamin D and bishosphonates was 3.5 per 1000 in 1995 with a female to male ratio of 6.8:1. Use was most common in the age group 75-79 years. Twenty-seven percent of the patients had used corticosteroids previously to being treated for osteoporosis; 1.4% of the patients had used cumulative corticosteroid doses greater than 10 g. These heavy users were treated with five times larger doses against osteoporosis than patients not treated with corticosteroids.

[Utilization of antibiotics in Denmark 1994-1995. A population-based study]. / Forbrug af antibiotika i Danmark 1994-1995. En populationsbaseret undersøgelse.

The aim of this study was to explore the potential of individualized drug statistics to provide various epidemiological measures of the utilization of antibiotics. The data derive from the Register of Drug Statistics at the Danish National Board of Health. The most important measures were DDD/1000 inhabitants/day, the number of patients and the distributions of prescriptions according to age and gender. The analysis encompassed 3,825,057 prescriptions presented by 1,670,801 patients during the period from 1 March 1994 to 31 May 1995. The overall consumption was 12.1 DDD/1000 inhabitants/day. Sixty-two percent of all patients and 84% of the patients receiving sulfonamides were female. The most frequent drug used was V-penicillin which was prescribed to 48% of the patients. The group which consumed the greatest part of sulfonamides and quinolones were older women over the age of 65. It was concluded that the Register of Drug Statistics provides important information on individualized drug utilization.