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Desmopressin: in adults with nocturia
Risto S Cvetković1, Greg L Plosker
1Adis International Limited, Auckland, New Zealand. demail@adis.co.nz
Drugs
|December 22, 2004
Summary
Desmopressin effectively treats nocturia (frequent nighttime urination) in adults with nocturnal polyuria or multiple sclerosis (MS). This antidiuretic hormone analogue improves sleep by reducing nighttime voids and extending uninterrupted sleep duration.
Area of Science:
- Pharmacology
- Nephrology
- Urology
Background:
- Desmopressin is the sole approved medication for nocturia linked to nocturnal polyuria or multiple sclerosis (MS).
- It offers superior antidiuretic effects over vasopressin without vasopressor or uterotonic activity.
Purpose of the Study:
- To evaluate the efficacy and safety of desmopressin in treating nocturia.
- To assess desmopressin's impact on nocturnal urine production and sleep patterns.
Main Methods:
- Two large, randomized, double-blind phase III trials were conducted in adults with nocturia.
- Subsequent non-blinded extension trials assessed long-term efficacy.
- Randomized, double-blind trials specifically investigated desmopressin in MS patients with nocturia.
Main Results:
- Oral desmopressin significantly reduced nocturnal voids and normalized urine production compared to placebo.
- Long-term treatment maintained and enhanced these beneficial effects.
- Nasal desmopressin reduced nocturnal voiding episodes by 31-54% in MS patients.
- Desmopressin increased uninterrupted sleep by approximately 2 hours in both populations.
Conclusions:
- Desmopressin is a well-tolerated and effective treatment for nocturia associated with nocturnal polyuria and MS.
- It significantly improves sleep quality by reducing nighttime urination.
- Adverse events were generally mild and transient, with a low incidence of clinically significant hyponatraemia.