The impact of adding low-dose oral desmopressin therapy to tamsulosin therapy for treatment of nocturia owing to benign prostatic hyperplasia

Ahmed, Abul-fotouh; Maarouf, Aref; Shalaby, Essam; Gabr, Ahmed H.; Shahin, Ashraf; Ghobish, Ammar

doi:10.1007/s00345-014-1378-2

Cited by 23 publications

(47 citation statements)

References 25 publications

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“…The addition of low‐dose oral desmopressin 50 μg to the α 1 ‐blocker tamsulosin has shown to reduce the nocturnal frequency of voids by 64.3% compared with 44.6% when tamsulosin was given alone in patients with signs or symptoms of BPH (with or without nocturnal polyuria) . The study also demonstrated that this combination therapy improved the quality of sleep, whilst overall tolerability remained comparable to tamsulosin monotherapy . Similar results have been seen when low‐dose desmopressin was added to other α 1 ‐blockers for men with LUTS/BPH .…”

Section: Resultssupporting

confidence: 55%

“…In cases with a multifactorial aetiology of nocturia, treatment could target the various underlying causes with two or more drugs and, if necessary, in a multidisciplinary setting, but should always involve lifestyle changes and behavioural therapies. The addition of low‐dose oral desmopressin 50 μg to the α 1 ‐blocker tamsulosin has shown to reduce the nocturnal frequency of voids by 64.3% compared with 44.6% when tamsulosin was given alone in patients with signs or symptoms of BPH (with or without nocturnal polyuria) . The study also demonstrated that this combination therapy improved the quality of sleep, whilst overall tolerability remained comparable to tamsulosin monotherapy .…”

Section: Resultsmentioning

confidence: 85%

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A practical approach to the management of nocturia

et al. 2017

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SummaryAimTo raise awareness on nocturia disease burden and to provide simplified aetiologic evaluation and related treatment pathways.MethodsA multidisciplinary group of nocturia experts developed practical advice and recommendations based on the best available evidence supplemented by their own experiences.ResultsNocturia is defined as the need to void ≥1 time during the sleeping period of the night. Clinically relevant nocturia (≥2 voids per night) affects 2%‐18% of those aged 20‐40 years, rising to 28%‐62% for those aged 70‐80 years. Consequences include the following: lowered quality of life; falls and fractures; reduced work productivity; depression; and increased mortality. Nocturia‐related hip fractures alone cost approximately €1 billion in the EU and $1.5 billion in the USA in 2014. The pathophysiology of nocturia is multifactorial and typically related to polyuria (either global or nocturnal), reduced bladder capacity or increased fluid intake. Accurate assessment is predicated on frequency‐volume charts combined with a detailed patient history, medicine review and physical examination. Optimal treatment should focus on the underlying cause(s), with lifestyle modifications (eg, reducing evening fluid intake) being the first intervention. For patients with sustained bother, medical therapies should be introduced; low‐dose, gender‐specific desmopressin has proven effective in nocturia due to idiopathic nocturnal polyuria. The timing of diuretics is an important consideration, and they should be taken mid‐late afternoon, dependent on the specific serum half‐life. Patients not responding to these basic treatments should be referred for specialist management.ConclusionsThe cause(s) of nocturia should be first evaluated in all patients. Afterwards, the underlying pathophysiology should be treated specifically, alone with lifestyle interventions or in combination with drugs or (prostate) surgery.

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Section: Resultssupporting

confidence: 55%

Section: Resultsmentioning

confidence: 85%

A practical approach to the management of nocturia

et al. 2017

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“…Desmopressin orally disintegrating tablets (ODT) were demonstrated to be safe and efficacious at a low‐dose (25 µg) in women, without additional clinical benefits at higher doses (50 and 100 µg) . A low‐dose (60 µg) formulation was safely combined with tamsulosin for controlling LUTS/benign prostatic hyperplasia in men …”

Section: Introductionmentioning

confidence: 99%

Low‐dose Desmopressin and Tolterodine Combination Therapy for Treating Nocturia in Women with Overactive Bladder: A Double‐blind, Randomized, Controlled Study

Raymond

Andruczyk²,

Juul

2017

LUTS

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“…The addition of desmopressin to α‐blocker therapy of 123 men with BPE and nocturia reduced the number of nocturnal voids by 64%, which was significantly better that the 45% reduction of 125 men treated with α‐blocker alone …”

Section: Discussionmentioning

confidence: 93%

Development of a multivariate prediction model for nocturia, based on urinary tract etiologies

et al. 2019

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Summary Purpose The main objective of our study was to determine which combination of modifiable and non‐modifiable parameters that could discriminate patients with nocturia from those without nocturia. This was a post‐hoc analysis of 3 prospective, observational studies conducted in Ghent University. Participants completed frequency volume chart (FVC) to compare characteristics between patients with and without nocturia. Method This was a post hoc analysis of three prospective, observational studies conducted in Ghent University. Participants completed frequency volume chart (FVC) to compare characteristics between adults with and without nocturia. Study 1: adults with and without nocturia (n = 148); Study 2: patients ≥65 years with and without nocturnal LUTS (n = 54); Study 3: menopausal women before and after hormone replacement therapy (n = 43). All eligible patients (n = 183) completed a FVC during 24 hours (n = 13), 48 hours (n = 30) or 72 hours (n = 140). The combination of algorithms and number of determinants obtaining the best average area under the receiver operating curve (AUC‐ROC) led to the final model. Differences between groups were assessed using the AUC‐ROC and Mann‐ Whitney‐Wilcoxon tests. Holm corrections were applied for multiple statistical testing. Also, the stability of the feature selection was evaluated. Results The best discrimination was obtained when 13 determinants were included. However, a logistic regression model based on seven determinants selected with random forest had comparable discrimination including an optimal signature stability. It was able to discriminate almost perfectly between nights with and without nocturia. Conclusion Relevant information to accomplish the excellent predictability of the model is; functional bladder capacity, 24 hours urine output, nocturnal output, age, BMI. The multivariate model used in this analysis provides new insights into combination therapy as it allows simulating the effect of different available treatment modalities and its combinations.

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The impact of adding low-dose oral desmopressin therapy to tamsulosin therapy for treatment of nocturia owing to benign prostatic hyperplasia

Abstract: The addition of low-dose oral desmopressin therapy to an α-blocker tamsulosin provides effective treatment for nocturia in patients with LUTS/BPH.

Cited by 23 publications

References 25 publications

A practical approach to the management of nocturia

A practical approach to the management of nocturia

Low‐dose Desmopressin and Tolterodine Combination Therapy for Treating Nocturia in Women with Overactive Bladder: A Double‐blind, Randomized, Controlled Study

Development of a multivariate prediction model for nocturia, based on urinary tract etiologies

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