Purpose: To investigate safety and effectiveness of oral desmopressin tablet (starting dose 0.1mg) in older Taiwanese men with nocturnal polyuria and nocturia, and to compare results in those aged ≥80 years vs <80 years.
Materials and methods: 234 Taiwanese males aged ≥60 years 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 Month 1, 2 and 3.
Results: 208 patients (88.9%) aged 60-95 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 yrs: -2.0; ≥80 yrs: -3.0) and urine volume (<80 yrs: -705 mL; ≥80 yrs: -660 mL), and increased hours of undisturbed sleep (<80 yrs: 1.0 h; ≥80 yrs: 2.0 h; all p<0.001). 39/234 (16.7%) discontinued desmopressin due to hyponatremia (determined via serum sodium monitoring). 28 patients with serum sodium decreases to ≤135 mmol/L continued treatment for the full 3 months with appropriate dose adjustments.
Conclusions: This study provides real-world evidence of effectiveness and safety of oral desmopressin in an older Asian male population, including a subgroup aged >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.
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