Desmopressin for treating nocturia in men

Julia Han, Jae Hung Jung, Caitlin J. Bakker, Mark H. Ebell, Philipp Dahm

Research output: Contribution to journalReview article

Abstract

Objectives: To assess the effects of desmopressin as compared to other interventions in the treatment of nocturia in men. Materials and Methods: We performed a comprehensive search using multiple databases and abstract proceedings with no restrictions on the language of publication or publication status, up until August 2017. We included randomised or quasi-randomised trials. Inclusion criteria were men with nocturia defined as one or more voids per night. Two review authors independently examined full-text reports, identified relevant studies, assessed the eligibility of studies for inclusion, extracted data, and assessed risk of bias. We performed statistical analyses using a random-effects model and assessed the quality of the evidence (QoE) according to Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Results: We included 14 studies with 2 966 randomised men across five comparisons (we did not include one comparison [desmopressin vs behaviour modification] in the abstract due to a lack of data with regard to primary outcomes). Desmopressin vs placebo: based on short-term follow-up (≤3 months), desmopressin may have a similar effect on the number of nocturnal voids (mean difference [MD] −0.46, 95% confidence interval [CI] −0.94 to 0.01; low QoE). We are uncertain about the effect of desmopressin on major adverse events (risk ratio [RR] 0.97, 95% CI: 0.10−9.03; very low QoE). For intermediate-term follow-up (3–12 months), desmopressin may reduce the number of nocturnal voids in an appreciable number of men (MD −0.85, 95% CI: −1.17 to −0.53; low QoE). Desmopressin may result in little or no difference in major adverse events (RR 3.05, 95% CI: 0.13–73.39; low QoE). We found no evidence on quality of life. Desmopressin vs α-blocker (AB): based on short-term follow-up, desmopressin likely has a similar effect on the number of nocturnal voids (MD 0.30, 95% CI: −0.20 to 0.80; moderate QoE) and quality of life (MD 0.00, 95% CI: −0.35 to 0.35; moderate QoE). There were no major adverse events in either study group. Desmopressin plus AB vs AB alone: based on short-term follow-up, combined therapy likely results in a small, unimportant reduction in the number of nocturnal voids (MD −0.47, 95% CI: −0.73 to −0.21; moderate QoE) and quality of life (MD −0.29, 95% CI: −0.51 to −0.07; moderate QoE). The risk of major adverse events may be similar (RR 0.30, 95% CI: 0.01–7.32; low QoE). Desmopressin plus AB vs AB plus an anticholinergic: based on short-term follow-up, combined therapy likely results in little or no difference in the number of nocturnal voids (MD −0.43, 95% CI: −0.97 to 0.11; moderate QoE). We found no evidence on quality of life. There were no major adverse events in either study group. Conclusions: Desmopressin may reduce the number of nocturnal voids compared to placebo up to 12 months of follow-up without increase in major adverse events. The effect on the number of nocturnal voids is likely similar to that of ABs with very infrequent major adverse events. There appears to be no added benefit in the combined use of an AB or an anticholinergic with desmopressin.

Original languageEnglish (US)
Pages (from-to)549-559
Number of pages11
JournalBJU International
Volume122
Issue number4
DOIs
StatePublished - Oct 1 2018

Fingerprint

Nocturia
Deamino Arginine Vasopressin
Confidence Intervals
Quality of Life
Odds Ratio
Cholinergic Antagonists
Publications
Placebos
Behavior Therapy

Keywords

  • desmopressin
  • men
  • nocturia
  • randomised controlled trials

ASJC Scopus subject areas

  • Urology

Cite this

Han, J., Jung, J. H., Bakker, C. J., Ebell, M. H., & Dahm, P. (2018). Desmopressin for treating nocturia in men. BJU International, 122(4), 549-559. https://doi.org/10.1111/bju.14183

Desmopressin for treating nocturia in men. / Han, Julia; Jung, Jae Hung; Bakker, Caitlin J.; Ebell, Mark H.; Dahm, Philipp.

In: BJU International, Vol. 122, No. 4, 01.10.2018, p. 549-559.

Research output: Contribution to journalReview article

Han, J, Jung, JH, Bakker, CJ, Ebell, MH & Dahm, P 2018, 'Desmopressin for treating nocturia in men', BJU International, vol. 122, no. 4, pp. 549-559. https://doi.org/10.1111/bju.14183
Han J, Jung JH, Bakker CJ, Ebell MH, Dahm P. Desmopressin for treating nocturia in men. BJU International. 2018 Oct 1;122(4):549-559. https://doi.org/10.1111/bju.14183
Han, Julia ; Jung, Jae Hung ; Bakker, Caitlin J. ; Ebell, Mark H. ; Dahm, Philipp. / Desmopressin for treating nocturia in men. In: BJU International. 2018 ; Vol. 122, No. 4. pp. 549-559.
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abstract = "Objectives: To assess the effects of desmopressin as compared to other interventions in the treatment of nocturia in men. Materials and Methods: We performed a comprehensive search using multiple databases and abstract proceedings with no restrictions on the language of publication or publication status, up until August 2017. We included randomised or quasi-randomised trials. Inclusion criteria were men with nocturia defined as one or more voids per night. Two review authors independently examined full-text reports, identified relevant studies, assessed the eligibility of studies for inclusion, extracted data, and assessed risk of bias. We performed statistical analyses using a random-effects model and assessed the quality of the evidence (QoE) according to Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Results: We included 14 studies with 2 966 randomised men across five comparisons (we did not include one comparison [desmopressin vs behaviour modification] in the abstract due to a lack of data with regard to primary outcomes). Desmopressin vs placebo: based on short-term follow-up (≤3 months), desmopressin may have a similar effect on the number of nocturnal voids (mean difference [MD] −0.46, 95{\%} confidence interval [CI] −0.94 to 0.01; low QoE). We are uncertain about the effect of desmopressin on major adverse events (risk ratio [RR] 0.97, 95{\%} CI: 0.10−9.03; very low QoE). For intermediate-term follow-up (3–12 months), desmopressin may reduce the number of nocturnal voids in an appreciable number of men (MD −0.85, 95{\%} CI: −1.17 to −0.53; low QoE). Desmopressin may result in little or no difference in major adverse events (RR 3.05, 95{\%} CI: 0.13–73.39; low QoE). We found no evidence on quality of life. Desmopressin vs α-blocker (AB): based on short-term follow-up, desmopressin likely has a similar effect on the number of nocturnal voids (MD 0.30, 95{\%} CI: −0.20 to 0.80; moderate QoE) and quality of life (MD 0.00, 95{\%} CI: −0.35 to 0.35; moderate QoE). There were no major adverse events in either study group. Desmopressin plus AB vs AB alone: based on short-term follow-up, combined therapy likely results in a small, unimportant reduction in the number of nocturnal voids (MD −0.47, 95{\%} CI: −0.73 to −0.21; moderate QoE) and quality of life (MD −0.29, 95{\%} CI: −0.51 to −0.07; moderate QoE). The risk of major adverse events may be similar (RR 0.30, 95{\%} CI: 0.01–7.32; low QoE). Desmopressin plus AB vs AB plus an anticholinergic: based on short-term follow-up, combined therapy likely results in little or no difference in the number of nocturnal voids (MD −0.43, 95{\%} CI: −0.97 to 0.11; moderate QoE). We found no evidence on quality of life. There were no major adverse events in either study group. Conclusions: Desmopressin may reduce the number of nocturnal voids compared to placebo up to 12 months of follow-up without increase in major adverse events. The effect on the number of nocturnal voids is likely similar to that of ABs with very infrequent major adverse events. There appears to be no added benefit in the combined use of an AB or an anticholinergic with desmopressin.",
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T1 - Desmopressin for treating nocturia in men

AU - Han, Julia

AU - Jung, Jae Hung

AU - Bakker, Caitlin J.

AU - Ebell, Mark H.

AU - Dahm, Philipp

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Objectives: To assess the effects of desmopressin as compared to other interventions in the treatment of nocturia in men. Materials and Methods: We performed a comprehensive search using multiple databases and abstract proceedings with no restrictions on the language of publication or publication status, up until August 2017. We included randomised or quasi-randomised trials. Inclusion criteria were men with nocturia defined as one or more voids per night. Two review authors independently examined full-text reports, identified relevant studies, assessed the eligibility of studies for inclusion, extracted data, and assessed risk of bias. We performed statistical analyses using a random-effects model and assessed the quality of the evidence (QoE) according to Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Results: We included 14 studies with 2 966 randomised men across five comparisons (we did not include one comparison [desmopressin vs behaviour modification] in the abstract due to a lack of data with regard to primary outcomes). Desmopressin vs placebo: based on short-term follow-up (≤3 months), desmopressin may have a similar effect on the number of nocturnal voids (mean difference [MD] −0.46, 95% confidence interval [CI] −0.94 to 0.01; low QoE). We are uncertain about the effect of desmopressin on major adverse events (risk ratio [RR] 0.97, 95% CI: 0.10−9.03; very low QoE). For intermediate-term follow-up (3–12 months), desmopressin may reduce the number of nocturnal voids in an appreciable number of men (MD −0.85, 95% CI: −1.17 to −0.53; low QoE). Desmopressin may result in little or no difference in major adverse events (RR 3.05, 95% CI: 0.13–73.39; low QoE). We found no evidence on quality of life. Desmopressin vs α-blocker (AB): based on short-term follow-up, desmopressin likely has a similar effect on the number of nocturnal voids (MD 0.30, 95% CI: −0.20 to 0.80; moderate QoE) and quality of life (MD 0.00, 95% CI: −0.35 to 0.35; moderate QoE). There were no major adverse events in either study group. Desmopressin plus AB vs AB alone: based on short-term follow-up, combined therapy likely results in a small, unimportant reduction in the number of nocturnal voids (MD −0.47, 95% CI: −0.73 to −0.21; moderate QoE) and quality of life (MD −0.29, 95% CI: −0.51 to −0.07; moderate QoE). The risk of major adverse events may be similar (RR 0.30, 95% CI: 0.01–7.32; low QoE). Desmopressin plus AB vs AB plus an anticholinergic: based on short-term follow-up, combined therapy likely results in little or no difference in the number of nocturnal voids (MD −0.43, 95% CI: −0.97 to 0.11; moderate QoE). We found no evidence on quality of life. There were no major adverse events in either study group. Conclusions: Desmopressin may reduce the number of nocturnal voids compared to placebo up to 12 months of follow-up without increase in major adverse events. The effect on the number of nocturnal voids is likely similar to that of ABs with very infrequent major adverse events. There appears to be no added benefit in the combined use of an AB or an anticholinergic with desmopressin.

AB - Objectives: To assess the effects of desmopressin as compared to other interventions in the treatment of nocturia in men. Materials and Methods: We performed a comprehensive search using multiple databases and abstract proceedings with no restrictions on the language of publication or publication status, up until August 2017. We included randomised or quasi-randomised trials. Inclusion criteria were men with nocturia defined as one or more voids per night. Two review authors independently examined full-text reports, identified relevant studies, assessed the eligibility of studies for inclusion, extracted data, and assessed risk of bias. We performed statistical analyses using a random-effects model and assessed the quality of the evidence (QoE) according to Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Results: We included 14 studies with 2 966 randomised men across five comparisons (we did not include one comparison [desmopressin vs behaviour modification] in the abstract due to a lack of data with regard to primary outcomes). Desmopressin vs placebo: based on short-term follow-up (≤3 months), desmopressin may have a similar effect on the number of nocturnal voids (mean difference [MD] −0.46, 95% confidence interval [CI] −0.94 to 0.01; low QoE). We are uncertain about the effect of desmopressin on major adverse events (risk ratio [RR] 0.97, 95% CI: 0.10−9.03; very low QoE). For intermediate-term follow-up (3–12 months), desmopressin may reduce the number of nocturnal voids in an appreciable number of men (MD −0.85, 95% CI: −1.17 to −0.53; low QoE). Desmopressin may result in little or no difference in major adverse events (RR 3.05, 95% CI: 0.13–73.39; low QoE). We found no evidence on quality of life. Desmopressin vs α-blocker (AB): based on short-term follow-up, desmopressin likely has a similar effect on the number of nocturnal voids (MD 0.30, 95% CI: −0.20 to 0.80; moderate QoE) and quality of life (MD 0.00, 95% CI: −0.35 to 0.35; moderate QoE). There were no major adverse events in either study group. Desmopressin plus AB vs AB alone: based on short-term follow-up, combined therapy likely results in a small, unimportant reduction in the number of nocturnal voids (MD −0.47, 95% CI: −0.73 to −0.21; moderate QoE) and quality of life (MD −0.29, 95% CI: −0.51 to −0.07; moderate QoE). The risk of major adverse events may be similar (RR 0.30, 95% CI: 0.01–7.32; low QoE). Desmopressin plus AB vs AB plus an anticholinergic: based on short-term follow-up, combined therapy likely results in little or no difference in the number of nocturnal voids (MD −0.43, 95% CI: −0.97 to 0.11; moderate QoE). We found no evidence on quality of life. There were no major adverse events in either study group. Conclusions: Desmopressin may reduce the number of nocturnal voids compared to placebo up to 12 months of follow-up without increase in major adverse events. The effect on the number of nocturnal voids is likely similar to that of ABs with very infrequent major adverse events. There appears to be no added benefit in the combined use of an AB or an anticholinergic with desmopressin.

KW - desmopressin

KW - men

KW - nocturia

KW - randomised controlled trials

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