Is an orally-disintegrating desmopressin tablet effective in nocturia?

This study investigated the benefit of an orally-disintegrating desmopressin (OD-DP; Minirin) tablet in nocturia caused by nocturnal polyuria (NP). They found that OD-DP tablets improved NP symptoms. 

Nocturia is a condition caused by repeated waking at night to urinate. There can be several causes of nocturia. One of these is nocturnal polyuria (NP). NP is the term for excess urine production at night. Normally a hormone called vasopressin (VP) regulates this. Patients with NP have lower levels of VP. 

Desmopressin (DP) is a synthetic form of VP. It helps regulate the bladder muscle. DP is formulated as an orally-disintegrating (OD) tablet. OD-DP has been shown to reduce nighttime waking. OD-DP may improve NP symptoms. The number of nighttime voids (NNV) is used to measure NP severity. Some experts think that reducing NNV is not the best indicator of treatment effectiveness. Quality of life (QoL) is also important in nocturia caused by NP. Both of these factors are a better indicator of clinical benefit. It is unclear if OD-DP has clinical benefit in patients with nocturia due to NP. 

This study included 2 trials in patients with nocturia caused by NP. 462 patients were included. Women were treated with 25 micrograms of OD-DP. Men were treated with 50 micrograms OD-DP. OD-DP was compared to a placebo in these patients. Improvement in NP was measured by the NNV. The treatment period lasted 3 months.

The NNV was reduced to a greater degree in men than women. QoL was not assessed in this study. More patients achieved a 33% and 50% reduction in NNV with OD-DP treatment compared to placebo in both men and women. Men treated with OD-DP had more nights with no urination at night compared to placebo. Both men and women had more nights with at most 1 void when treated with OD-DP compared to placebo.

The authors concluded that OD-DP tablets improved NP symptoms.

QoL was not measured in this study. This means that although NNV was reduced we do not know if patients reported a clinical benefit. Also, the doses used for men and women were different in the 2 studies. 

If you have any concerns regarding nocturia please consult with your doctor.