Efficacy and safety of desmopressin in women with nocturia: a systematic review and meta-analysis of randomized controlled trials

Cai, Xiang; Tian, Yiyang; Nie, Ming; Wang, Kunjie

doi:10.1007/s11255-019-02242-x

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…In women, there was a significant reduction in nocturnal voids (on average 0.5 fewer voids/night compared to placebo), and a significant increase in the duration of the first period of sleep by about one hour. 101 The magnitude of effect was quite similar in men, 102 and likely has similar efficacy as alpha-blockers in terms of reducing episodes of nocturia in men. In male patients, randomised trials have demonstrated that Desmopressin may be synergistic with alpha blockers, 103 however this has been questioned by systematic reviews.…”

Section: Pharmacologic Treatment Of Nocturnal Polyuriamentioning

confidence: 83%

Canadian Urological Association best practice report: Diagnosis and management of nocturia

Nguyen

Randhawa

Nadeau

et al. 2022

CUAJ

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relevant articles were also reviewed to identify any other relevant important studies. Quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. While there overall was a lack of high-quality evidence to inform aspects of this review, the strength of recommendations was supported by clinical principles, fundamental pathophysiology, and consensus expert opinion. BackgroundThe International Continence Society (ICS) defines nocturia as waking one or more times to void during the hours of sleep, with each void preceded and followed by sleep. 1 Although voiding even once at night is considered nocturia, some literature has shown that fewer than two voids per night does not result in significant patient bother. 2 However, the degree of bother experienced by individual patients will vary according to factors beyond just the number of voids per night. Nocturia is associated with impaired quality of life, 3 and even mortality. 4 This association of nocturia with mortality has been reported to be independent of bother, and should be noted even if patients are not bothered. 5 Patients therefore may benefit from assessment for nocturia even if they don't independently report nocturia, as bother is often what motivates patients to raise nocturia as an issue with their care providers.Depending on the patient population and definition of nocturia used, prevalence varies significantly. [6][7][8] From a Canadian survey of 1000 adults, prevalence, using the ICS definition of one or more episodes per night, was estimated to be 36.4% in all adults and 49.5% in adults over age 65. When defined as two or more episodes per night, prevalence was 9.1% in all adults and 23.8% in adults over the age of 65. 9 Nocturia by any definition increases with age, particularly in men (see Figure 1). 6,7,9 Normal renal function allows for a circadian production of urine, with concentration of urine at night. This function is age-dependent, typically established by age 3 to 5, and leads to decreased nocturnal urine volume. Arginine vasopressin (AVP, or antidiuretic hormone [ADH]) is released from the posterior pituitary and serves as the primary hormone regulating renal water excretion. Factors such as high serum osmolality, hypovolemia and angiotensin II stimulate AVP, leading to water reabsorption, whereas factors such as atrial natriuretic peptide (ANP/ANH), prostaglandin E2 (PGE2) and hypercalcemia inhibit AVP, leading to diuresis. 10 With aging, however, the circadian rhythm of release of these hormones is blunted, which can increase nocturnal urine production.Normal bladder function requires adequate bladder storage and emptying abilities. This requires coordination of multiple components, including the central and peripheral nervous systems, detrusor smooth muscle function, and urethral and pelvic floor function. In addition, the bladder urothelium seems to have a role in regulating urinary function and possibly contributing to AVP-mediated water homeostasis. 10 Important co...

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Section: Pharmacologic Treatment Of Nocturnal Polyuriamentioning

confidence: 83%

Canadian Urological Association best practice report: Diagnosis and management of nocturia

Nguyen

Randhawa

Nadeau

et al. 2022

CUAJ

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“…Additionally, clear circadian boundaries in activities, such as exercise in the evening 27 , taking a bath 1–2 h before bedtime 28 , and light exposure in the morning 29 could reduce nocturnal urination and may prevent incident poor sleep and disruption of deep sleep, thereby extending healthy life expectancy. Desmopressin administration to patients with nocturnal polyuria has additionally been shown to significantly improve both nocturia and the duration of the first sleep period 30 . Proactive interventions for poor sleep caused by stress, depression, alcohol consumption, and lifestyle disturbances would also be desirable in terms of prevention of nocturia.…”

Section: Discussionmentioning

confidence: 99%

Risk analyses of nocturia on incident poor sleep and vice versa: the Nagahama study

Negoro¹,

Setoh²,

Fukunaga³

et al. 2023

Sci Rep

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Cross-sectional relationships between nocturia and sleep problems have been well evaluated but the risk association for each incidence is scarcely reported. This analysis included 8076 participants of the Nagahama study in Japan (median age 57, 31.0% male) and associations between nocturia and self-reported, sleep-related problems (poor sleep) were evaluated cross-sectionally. Causal effects on each new-onset case were analyzed longitudinally after 5 years. Three models were applied: univariable analysis, adjustment for basic variables (i.e., demographic and lifestyle variables) and full adjustment for basic and clinical variables. The overall prevalences of poor sleep and nocturia were 18.6% and 15.5%, while poor sleep was positively associated with nocturia (OR = 1.85, p < 0.001) and vice versa (OR = 1.90, p < 0.001). Among 6579 good sleep participants, 18.5% developed poor sleep. Baseline nocturia was positively associated with this incident poor sleep (OR = 1.49, p < 0.001, full adjustment). Among 6824 non-nocturia participants, the nocturia incidence was 11.3%. Baseline poor sleep was positively associated with this incident nocturia (OR = 1.26, p = 0.026); such associations were significant only in women (OR = 1.44, p = 0.004) and under-50-year-old groups (OR = 2.82, p < 0.001), after full adjustment. Nocturia and poor sleep associate with each other. Baseline nocturia can induce new-onset poor sleep while baseline poor sleep may induce new-onset nocturia only in women.

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Systematic review and meta-analysis of randomized control trials addressing efficacy and safety of desmopressin for females with nocturia

et al. 2023

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Efficacy and safety of desmopressin in women with nocturia: a systematic review and meta-analysis of randomized controlled trials

Cited by 4 publications

References 24 publications

Canadian Urological Association best practice report: Diagnosis and management of nocturia

Canadian Urological Association best practice report: Diagnosis and management of nocturia

Risk analyses of nocturia on incident poor sleep and vice versa: the Nagahama study

Systematic review and meta-analysis of randomized control trials addressing efficacy and safety of desmopressin for females with nocturia

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