Endocrine Abstracts

Background: Antidiuretic analogue desmopressin was tested in its intranasal form in renal colic, with variable effects.

Aims: We evaluated the effects of sublingual desmopressin in lithiasic renal colic, alone or combined with a non-steroidal antiinflammatory drug (NSAID).

Materials and methods: Our prospective single-blind study included an initial number of 371 patients with lithiasic renal colic randomized as follows: group NSAID (93 patients) received ketorolac 30 mg im, groups D60 and D120 (84 and 61 patients) received sublingual Minirin Melt, 60 and 120 μg respectively, whereas groups C60 and C120 (63 and 70 patients) received combinations of ketorolac and Minirin Melt. Pain intensity was assessed using the visual analogue scale before and thirty minutes after drug administration. Patients experiencing pain aggravation were rescued and excluded from the study.

Results: Dropout incidence was higher in the NSAID group than in the groups treated with desmopressin in monotherapy or combined with ketorolac (P<0.05). Pain intensity was diminished at least as potently by the therapy with desmopressin and ketorolac. The higher dose of desmopressin and combination therapies decreased pain intensity more than ketorolac alone (P<0.05). Mean pain decrease was higher in the pooled combination group (C) than in the NSAID group or pooled group treated with desmopressin in monotherapy (D) (P<0.05). Patients did not experience side effects and their blood pressure remained constant in all groups.

Conclusions: Sublingual desmopressin is at least as potent as NSAID in the treatment of lithiasic renal colic. Combinations of sublingual desmopressin and NSAID have additive analgesic effects.