Evaluating the long-term effects of desmopressin treatment in older people with nocturia

This study evaluated the long-term effectiveness and safety of desmopressin (Minirin Melt^®) treatment in older people with nocturia. The research found that this treatment was well-tolerated in the long term in these patients. 

Older people often wake up during the night to urinate (nocturia). This leads to low sleep quality and increased risks of a decreased quality of life. Treating nocturia is often difficult. Many patients can also experience nocturia after some treatments.

Oral desmopressin is a synthetic form of vasopressin, a hormone released by the pituitary gland that is involved in urine retention. Oral desmopressin is used to reduce the production of urine by the kidney. However, most studies evaluated the short-term safety and effects of oral desmopressin. It is important to evaluate the long-term effectiveness and safety of using oral desmopressin, particularly in older people with nocturia.

The study involved 133 male patients with an average age of 77 years with nocturia. Nocturia was defined as getting up from sleep to urinate two or more times. All patients received 50 µg of oral desmopressin daily, before bedtime. They were advised to keep bladder diaries that evaluated nighttime urine frequency, the amount of urine produced during 24 hours, and sleep quality. Body composition was also evaluated by measuring the body weight, body water, body fat, and muscle mass. Patients were followed up for up to 1 year. 

87.6% of patients reported improved symptoms after 1 year compared to before treatment. There was a significant reduction in nighttime urine quantity after 52 weeks of treatment. However, there was no difference in daily urination frequency between 12 and 52 weeks of treatment. There were significant improvements in sleep scores after 52 weeks of treatment.

 Overall, 36.1% of patients stopped the treatment before 52 weeks. The most common reasons were low sodium levels (23.3% of patients), hives, and stomach pain. There was no significant effect of the treatment on body compositions after 1 year.

The study concluded that long-term oral treatment of desmopressin was effective and well-tolerated in older people with nocturia.

The study included only male patients in Japan. It was also based on patients' memory reports, which can be biased. Other studies are needed on larger and more diverse populations.