Upcoming New Drug Therapies for Nocturia - A Nonsystematic Stepwise Review

Current treatment options for nocturia are unsatisfactory, prompting review of clinical studies of potential new and better drug therapies for nocturia. A 3-step nonsystematic review was performed. Step 1 was to review articles related to nocturia in multiple databases. Step 2 was to review articles identified in Step 1 for potential new and better drug therapies for nocturia. Step 3 was to review the websites of companies sponsoring new drug therapies. Two categories of potential new drugs were identified. Category 1 drugs include new drugs, new drug combinations, or new routes of administration of drugs that are in the existing class for nocturia. They are: (a) demospressin combined with tamsulosin (an alpha-1 blocker), solifenacin (an antimuscarinic), or furosemide (a diuretic); (b) mirabegron (a β3- agonist) combined with tamsulosin or solifenacin, or new β3-agonists (solabegron and vibegron); (c) tolterodine (an antimuscarinic agent) combined with pilocarpine (a short-acting muscarinic agonist selective for salivary gland receptors); and (d) intravesical instillation of botulinum toxin A. Category 2 drugs are new drugs with novel molecular targets. They include Paxerol (prostaglandin E2 inhibitors) and Fedovapagon (a vasopressin V2 receptor agonist). Conclusion: Category 1 potential new drug therapies have improved efficacy and/or tolerability compared to parent drugs. Due to novel molecular targets, Category 2 drugs provide additional treatment options, especially in patients who have failed current therapies, current unsatisfactory, or cannot tolerate current drug therapies.