Real-World Safety and Effectiveness of an Initial 0.1 mg Dose of Desmopressin in Older Men with Nocturnal Polyuria.

Abstract

To investigate safety and effectiveness of oral desmopressin tablet (starting dose 0.1 mg) in older Taiwanese men with nocturnal polyuria and nocturia and to compare results in those aged ≥ 80 years vs < 80 years. Two hundred thirty-four Taiwanese men aged 60 years or older with nocturia (≥2 voids/night) and a nocturnal polyuria index of ≥ 33 were included. Patients received desmopressin 0.1 mg for up to 3 months. Effectiveness was evaluated at Month 1, and safety was assessed at Months 1, 2, and 3. Two hundred eight patients (88.9%) aged 60 to 95 years provided follow-up data. 70.1% of participants completed the 3-month treatment period. Desmopressin was associated with significantly reduced median nocturnal voids/night (<80 years: -2.0; ≥80 years: -3.0) and urine volume (<80 years: -705 mL; ≥80 years: -660 mL) and increased hours of undisturbed sleep (<80 years: 1.0 hours; ≥80 years: 2.0 hours; all <i>P</i> < .001). In total, 39/234 (16.7%) discontinued desmopressin due to hyponatremia (determined through serum sodium monitoring). Twenty-eight patients with serum sodium decreases to ≤ 135 mmoL/L continued treatment for the full 3 months with appropriate dose adjustments. This study provides real-world evidence of effectiveness and safety of oral desmopressin in an older Asian male population, including a subgroup aged older than 80 years. A starting dose of 0.1 mg oral desmopressin, coupled with careful serum sodium monitoring and dose adjustment if required, was associated with significant improvement in all nocturia parameters and a high rate of continuation.