Determining the optimal initial dose for Japanese patients with nocturnal polyuria using an initial dose of desmopressin 50 μg.
desmopressin
hyponatremia
nocturnal polyuria
optimal initial dose
safety
Journal
Lower urinary tract symptoms
ISSN: 1757-5672
Titre abrégé: Low Urin Tract Symptoms
Pays: Australia
ID NLM: 101506777
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
revised:
06
01
2023
received:
05
12
2022
accepted:
27
01
2023
medline:
28
4
2023
pubmed:
10
2
2023
entrez:
9
2
2023
Statut:
ppublish
Résumé
There is no consistent opinion on the optimal initial dose of desmopressin for patients with nocturnal polyuria. Over a period of 12 weeks, we investigated the safety and efficacy of an initial dose of 50 μg of desmopressin for elderly men. Eighty patients (mean age: 78.8 years) were started on an initial dose of 50 μg of desmopressin for nocturia associated with nocturnal polyuria. Safety and efficacy were evaluated after 1, 4, and 12 weeks using a frequency-volume chart, Athens Insomnia Scale, Patient Global Impression of Improvement scale, physical examination, blood tests, and a body composition analyzer. Along with reduction in the frequency and volume of night-time urination, improvements in hours of undisturbed sleep, nocturnal polyuria index, and International Prostate Symptom Score, and Overactive Bladder Symptom Scores on quality of life measures were also observed. Hyponatremia was observed in 15 patients (18.7%). However, only 5.0% of patients had hyponatremia after the dose was reduced to 25 μg, and the continuation rate at 12 weeks was high at 87.5%. Age and other physical factors, such as body mass index, body water content, body fat mass, and muscle mass were not significant predictors of adverse events. Our study suggests that an initial dose of 50 μg is more effective than a uniformly minimum dose based on factors such as age and physique. Furthermore, a high continuation rate can be achieved by appropriately reducing the dose, if adverse events occur.
Substances chimiques
Deamino Arginine Vasopressin
ENR1LLB0FP
Antidiuretic Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
89-95Informations de copyright
© 2023 John Wiley & Sons Australia, Ltd.
Références
Hashim H, Blanker MH, Drake MJ, et al. International continence society (ICS) report on the terminology for nocturia and nocturnal lower urinary tract function. NeurourolUrodyn. 2019;38:499-508.
Bliwise DL, Rosen RC, Baum N. Impact of nocturia on sleep and quality of life: a brief, selected review for the international consultation on incontinence research society (ICI-RS) nocturia think tank. NeurourolUrodyn. 2014;33(Suppl 1):S15-S18.
Nakagawa H, Niu K, Hozawa A, et al. Impact of nocturia on bone fracture and mortality in older individuals: a Japanese longitudinal cohort study. J Urol. 2010;184:1413-1418.
Weiss JP, van Kerrebroeck PE, Klein BM, Nørgaard JP. Excessive nocturnal urine production is a major contributing factor to the etiology of nocturia. J Urol. 2011;186:1358-1363.
Chang SC, Lin AT, Chen KK, Chang LS. Multifactorial nature of male nocturia. Urology. 2006;67(3):541-544.
Soldatos CR, Dikeos DG, Paparrigopoulos TJ. Athens insomnia scale: validation of an instrument based on ICD-10 criteria. J Psychosom Res. 2000;48:555-560.
Kyoda Y, Kimura M, Shimizu T, et al. Efficacy and safety of desmopressin orally disintegrating tablets 25 and 50 μg in male patients with nocturia: a Japanese real-world multicenter clinical study. Low Urin Tract Symptoms. 2022;14:410-415.
Yamaguchi O, Juul KV, Falahati A, Yoshimura T, Imura F, Kitamura M. Efficacy and safety of 25 and 50 μg desmopressin orally disintegrating tablets in Japanese patients with nocturia due to nocturnal polyuria: results from two phase 3 studies of a multicenter randomized double-blind placebo-controlled parallel-group development program. Low Urin Tract Symptoms. 2020;12:8-19.
Hayashi K, Fuji K, Omizu M, et al. Efficacy and safety of 25 and 50 μg desmopressin orally disintegrating tablets in nocturia due to nocturnal polyuria in Japanese male patients. The Japanese Journal of Urology. 2021;112:159-167.
Yalcin I, Bump RC. Validation of two global impression questionnaires for incontinence. Am J Obstet Gynecol. 2003;189:98-101.
Srikrishna S, Robinson D, Cardozo L. Validation of the patient global impression of improvement (PGI-I) for urogenital prolapse. Int Urogynecol J. 2010;21:523-528.
Yokoyama O, Yoshida M, Kim SC, et al. Tadalafil once daily for lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a randomized placebo- and tamsulosin-controlled 12-week study in Asian men. Int J Urol. 2013;20:193-201.
Bae WJ, Bae JH, Kim SW, et al. Desmopressin add-on therapy for refractory nocturia in men receiving α-blockers for lower urinary tract symptoms. J Urol. 2013;190:180-186.
Furuta A, Suzuki Y, Igarashi T, Koike Y, Egawa S. Effect of low-dose desmopressin on nocturia due to nocturnal polyuria in men and serum sodium levels. Jpn J Urol Surg. 2021;34:1260-1265.
Carlson KV, Rovner ES, Nair KV, Deal AS, Kristy RM, Hairston JC. Persistence with mirabegron or antimuscarinic treatment for overactive bladder syndrome: findings from the PERSPECTIVE registry study. Low Urin Tract Symptoms. 2021;13:425-434.
Wagg A, Compion G, Fahey A, Siddiqui E. Persistence with prescribed antimuscarinic therapy for overactive bladder: a UK experience. BJU Int. 2012;110:1767-1774.