In a nutshell
This review evaluated the long-term effects and safety of desmopressin (Minirin) for the treatment of nocturia.
Researchers concluded that desmopressin is a safe and effective treatment option for nocturia.
Some background
A common symptom of benign prostatic hyperplasia (BPH) is nocturia, the need to wake up and pass urine during the night. Nocturia is one of the most frequently reported and bothersome symptoms among men with BPH, and it can lead to significant sleep disturbances. Desmopressin (Minirin) is a common treatment for nocturia. Desmopressin works by signaling the kidneys to produce less urine, and therefore reduce the need to urinate during nighttime. However, the long-term effects and safety of desmopressin are still under examination.
Methods & findings
This study examined the long-term safety of desmopressin in men with BHP.
The results of three separate randomized trials, involving 757 patients with nocturia, were combined. Treatment effectiveness, mode of administration (orally disintegrating tablet or solid tablet) and dosage were analyzed over an average of 4 years.
The initial period of undisturbed sleep before treatment was 2.4 to 3 hours. This period increased by up to 2.6 hours after four years of treatment with desmopressin. Overall, the number of nocturia episodes per night steadily decreased over time.
After 4 years, the average number nocturia episodes per night among those treated with the orally disintegrating tablet was 1.9 in patients receiving 25 micrograms, 1.6 in patients receiving 50 micrograms and 1.1 in patients receiving 100 micrograms. This is compared to an average of 3 voids per night before treatment.
After four years of treatment with the desmopressin solid tablet, number of voids per night decreased by 1.7 in patients receiving 200 micrograms and by 1.5 in patients receiving 400 micrograms.
An improvement in nocturia episodes of 50% or more was generally more common among patients receiving a higher dosage.
Dry mouth, headache, high blood pressure, nasal congestion, and cold or flu-like symptoms were most commonly associated with long-term treatment with desmopressin. However, the overall rate of side effects was low and less than 2% of patients discontinued treatment due to side-effects.
The bottom line
The researchers concluded that desmopressin is a safe and effective long-term treatment for patients experiencing nocturia.
Published By :
Neurourology and urodynamics
Date :
Apr 01, 2013
