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World Journal of Urology

Published in:

01-10-2014 | Topic Paper

Impact of desmopressin on nocturia due to nocturnal polyuria in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH)

Authors: Richard Berges, Klaus Höfner, Michael Gedamke, Matthias Oelke

Published in: World Journal of Urology | Issue 5/2014

Abstract

Purpose

To evaluate the efficacy of desmopressin on nocturia, quality of sleep (QoS), and health-related quality of life (HRQoL) in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) and nocturia due to nocturnal polyuria (NP) as the predominant symptom.

Methods

A German observational, multicenter, post-marketing surveillance study including men with LUTS/BPH and nocturia due to NP starting 3 months of desmopressin treatment.

Results

In total, 137 patients with a mean of 3.8 nocturnal voids (range 2–7) were included. Desmopressin significantly reduced the mean number of nocturnal voids by 53 %, mean IPSS nocturia question by 50 %, and the mean ratio of night/24-h urine volume by 39 % from baseline to endpoint. The hours of undisturbed sleep significantly increased by 74 %; 71 % of men reported about undisturbed sleep of ≥4 h at study end. Additionally, there was a significant reduction in the Leeds Sleep Evaluation Questionnaire score, indicating a clinically relevant QoS improvement. This was associated with an improved HRQoL, as shown by a significant improvement in both the mean IPSS-QoL question by 43 % and mean ICIQ-N nocturia problem question by 53 %. Concomitant alpha-blocker use had no effect on the efficacy of desmopressin. The incidence of adverse events was low (2.2 %). Hyponatremia was not observed in any patient. The majority of patients and physicians rated the efficacy and tolerability of desmopressin as good/very good.

Conclusions

Desmopressin is an effective and well-tolerated treatment for nocturia due to NP in patients with LUTS/BPH in daily practice under routine conditions.

van Kerrebroeck P, Abrams P, Chaikin D, Donovan J, Fonda D, Jackson S, Jennum P, Johnson T, Lose G, Mattiasson A, Robertson G, Weiss J (2002) The standardisation of terminology in nocturia: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21(2):179–183PubMedCrossRef

Tikkinen KA, Johnson TM 2nd, Tammela TL, Sintonen H, Haukka J, Huhtala H, Auvinen A (2010) Nocturia frequency, bother, and quality of life: how often is too often? A population-based study in Finland. Eur Urol 57(3):488–496PubMedCrossRef

Weiss JP, Blaivas JG, Bliwise DL, Dmochowski RR, Dubeau CE, Lowe FC, Petrou SP, Van Kerrebroeck PE, Rosen RC, Wein AJ (2011) The evaluation and treatment of nocturia: a consensus statement. BJU Int 108(1):6–21PubMedCrossRef

Oelke M, Wiese B, Berges R (2014) Nocturia and its impact on health related quality of life and health care seeking behaviour in German community-dwelling men aged 50 years or older. World J Urol. doi:10.1007/s00345-014-1374-6

van Kerrebroeck P (2002) Standardization of terminology in nocturia: commentary on the ICS report. BJU Int 90(Suppl 3):16–17PubMedCrossRef

Rembratt A, Norgaard JP, Andersson KE (2003) Nocturia and associated morbidity in a community-dwelling elderly population. BJU Int 92(7):726–730PubMedCrossRef

Chang SC, Lin AT, Chen KK, Chang LS (2006) Multifactorial nature of male nocturia. Urology 67(3):541–544PubMedCrossRef

Stanley N (2005) The physiology of sleep and the impact of ageing. Eur Urol Suppl 3:17–23

Abrams P (2005) Nocturia: the effect on sleep and related health consequences. Eur Urol Suppl 3:1–7CrossRef

10.

Asplund R (2005) Nocturia: consequences for sleep and daytime activities and associated risks. Eur Urol Suppl 3:24–32CrossRef

11.

Dijk DJ, Groeger JA, Stanley N, Deacon S (2010) Age-related reduction in daytime sleep propensity and nocturnal slow wave sleep. Sleep 33(2):211–223PubMedPubMedCentral

12.

Akerstedt T, Nilsson PM (2003) Sleep as restitution: an introduction. J Intern Med 254:6–12PubMedCrossRef

13.

Asplund R (1999) Mortality in the elderly in relation to nocturnal micturition. BJU Int 84(3):297–301PubMedCrossRef

14.

Bonnet MH, Arand DL (2003) Clinical effects of sleep fragmentation versus sleep deprivation. Sleep Med Rev 7:297–310PubMedCrossRef

15.

Abrams P (2005) Nocturia: the major problem in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction (LUTS/BPO). Eur Urol Suppl 3:8–16CrossRef

16.

van Kerrebroeck P (2011) Nocturia: current status and future perspectives. Curr Opin Obstet Gynecol 23(5):376–385PubMed

17.

Oelke M, Bachmann A, Descazeaud A, Emberton M, Gravas S, Michel MC, N’Dow J, Nordling J, de la Rosette JJ (2013) EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 64(1):118–140PubMedCrossRef

18.

Eisenhardt A, Schneider T, Cruz F, Oelke M (2014) Consistent and significant improvement of nighttime voiding frequency (nocturia) with silodosin in men with LUTS suggestive of BPH: pooled analysis of three randomized, placebo-controlled, double-blind phase III studies. World J Urol. doi:10.1007/s00345-013-1228-7 PubMed

19.

Oelke M, Roehrborn CG, D’Ancona C, Wilson TH, Castro R, Manyak M (2014) Nocturia improvement in the combination of Avodart and tamsulosin (CombAT) study. World J Urol. doi:10.1007/s00345-014-1296-3

20.

Oelke M, Roehrborn CG, D’Ancona C, Wilson TH, Castro R, Manyak M (2014) Nocturia improvement with dutasteride in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH): a pooled analysis of three phase III studies. World J Urol. doi:10.1007/s00345-014-1316-3

21.

Oelke M, Weiss JP, Mamoulakis C, Cox D, Ruff D, Viktrup L (2014) Effects of tadalafil on nighttime voiding (nocturia) in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a post hoc analysis of pooled data from four randomized, placebo-controlled clinical studies. World J Urol. doi:10.1007/s00345-014-1255-z

22.

Oelke M, Berges R, Schlafke S, Burkart M (2014) Fixed-dose combination PRO 160/120 of sabal and urtica extracts improves nocturia in men with LUTS suggestive of BPH: re-evaluation of four controlled clinical studies. World J Urol. doi:10.1007/s00345-014-1338-x

23.

Andersson KE, Appell R, Cardozo L (2005) Pharmalogical treatment of urinary incontinence. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence. 3rd international consultation on incontinence. Health Publication Ltd, Paris, pp 809–854

24.

Fonda D, DuBeau C, Harari D, Ouslander JG, Palmer M, Roe B (2005) Incontinence in the frail elderly. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence (3rd international consultation on incontinence. Health Publication Ltd, Paris, pp 1163–1240

25.

Mattiasson A, Abrams P, van Kerrebroeck P, Walter S, Weiss J (2002) Efficacy of desmopressin in the treatment of nocturia: a double-blind placebo-controlled study in men. BJU Int 89(9):855–862PubMedCrossRef

26.

van Kerrebroeck P, Rezapour M, Cortesse A, Thüroff J, Riis A, Norgaard JP (2007) Desmopressin in the treatment of nocturia: a double-blind, placebo-controlled study. Eur Urol 52(1):221–229PubMedCrossRef

27.

Lose G, Mattiasson A, Walter S, Lalos O, van Kerrebroeck P, Abrams P, Freeman R (2004) Clinical experiences with desmopressin for long-term treatment of nocturia. J Urol 172(3):1021–1025PubMedCrossRef

28.

Barry MJ, Fowler FJ Jr, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK (1995) Measuring disease-specific health status in men with benign prostatic hyperplasia. Measurement Committee of the American Urological Association. Med Care 33(4 Suppl):AS145–AS155

29.

Rodrigues P, Meller A, Campagnari JC, Alcantara D, D’Imperio M (2004) International Prostate Symptom Score–IPSS-AUA as discriminant scale in 400 male patients with lower urinary tract symptoms (LUTS). Int Braz J Urol 30(2):135–141PubMedCrossRef

30.

McKown S, Abraham L, Coyne K, Gawlicki M, Piault E, Vats V (2010) Linguistic validation of the N-QOL (ICIQ), OAB-q (ICIQ), PPBC, OAB-S and ICIQ-MLUTSsex questionnaires in 16 languages. Int J Clin Pract 64(12):1643–1652PubMedCrossRef

31.

Parrott AC, Hindmarch I (1980) The Leeds Sleep Evaluation Questionnaire in psychopharmacological investigations—a review. Psychopharmacology 71(2):173–179PubMedCrossRef

32.

Meadows R, Venn S, Hislop J, Stanley N, Arber S (2005) Investigating couples’ sleep: an evaluation of actigraphic analysis techniques. J Sleep Res 14(4):377–386PubMedCrossRef

33.

Lose G, Lalos O, Freeman RM, van Kerrebroeck P, Nocturia Study Group (2003) Efficacy of desmopressin (Minirin) in the treatment of nocturia: a double-blind placebo-controlled study in women. Am J Obst Gynecol 189(4):1106–1113

34.

Vande Walle J, Stockner M, Raes A, Norgaard JP (2007) Desmopressin 30 years in clinical use: a safety review. Curr Drug Saf 2:232–238PubMedCrossRef

35.

Juul KV, Klein BM, Sandstrom R, Erichsen L, Norgaard JP (2011) Gender difference in antidiuretic response to desmopressin. Am J Physiol Renal Physiol 300(5):F1116–F1122PubMedCrossRef

Title: Impact of desmopressin on nocturia due to nocturnal polyuria in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH)
Authors: Richard Berges
Klaus Höfner
Michael Gedamke
Matthias Oelke
Publication date: 01-10-2014
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 5/2014
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-014-1381-7

At a glance: The STEP trials

Springer Medicine

Impact of desmopressin on nocturia due to nocturnal polyuria in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH)

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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