In a nutshell
This study investigated the safety and efficacy of desmopressin (DDAVP) in adults with nocturia. The authors concluded that desmopressin appears to be a safe, effective treatment for nocturia in generally healthy adults.
Some background
Despite the great effect of nocturia on millions of people worldwide, current therapies for nocturia have limited effectiveness.
Desmopressin is a synthetic version of the hormone vasopressin. This hormone normally regulates urine production, and is low in nocturia patients during the night. This leads to increased nighttime urination (voids).
Desmopressin is commonly used to decrease urine production in patients with other medical conditions, but has only recently been tested for the treatment of nocturia.
Methods & findings
This study analyzed data from 2,191 patients with nocturia across ten studies. 64.4% of patients received desmopressin (treatment group) and 35.6% received placebo (control group).
Overall, treated patients had 0.5 fewer night voids compared to the control group. The average number of voids per night decreased with higher doses. 0.38 fewer trips to the toilet were noted with low dose treatment, and 0.72 fewer with high doses (100mcg or higher).
Treated patients received 58 more minutes of sleep compared to the control group. Higher treatment doses had a statistically significant increase in minutes of sleep received, ranging from 19 to 126 more minutes.
In six out of ten studies, treated patients reported headaches. In nine out of ten studies, low levels of sodium in the blood (hyponatremia) were noted. Patients receiving treatment had a 3.3 times increased risk of headaches and a 3.6 times increased risk of low blood sodium.
The bottom line
The authors concluded that desmopressin is a safe, effective treatment for nocturia in generally healthy adults.
The fine print
Four out of ten studies analyzed in the current study had a trial period for treatment doses. These studies excluded patients who experienced side effects or did not respond to treatment, creating bias. This study was also limited by the highly varied study population, including different doses, study designs, age, and gender. The analyzed studies also inconsistently reported side effects.
The risk of low blood sodium levels with desmopressin treatment requires careful monitoring.
More studies with longer followup are needed to further investigate the long-term benefits and side effects of desmopressin.
What’s next?
Talk to your doctor about the potential benefits and side effects associated with desmopressin.
Published By :
Journal of Urology
Date :
Sep 01, 2014
