Efficacy and Safety of Desmopressin "Add-On" Therapy in Men with Persistent Nocturia Under Alpha Blocker Monotherapy for Lower Urinary Tract Symptoms: A Randomized, Double-Blind, Placebo-Controlled Study

We investigated the efficacy and safety of desmopressin add-on therapy in men with persistent nocturia on alpha-blocker for lower urinary tract symptoms (LUTS) with placebo-controlled study.

The study included men aged 40-65 years with LUTS and persistent nocturia despite alpha-blocker for at least 8 weeks. The patients were randomized to once-daily placebo or desmopressin 0.2 mg for 8 weeks. The primary end point was to assess changes in the mean number of nocturia episodes from the baseline to the final assessment. Other secondary end points and adverse events were evaluated.

In all, 86 patients were randomized to receive placebo (n = 39) or desmopressin 0.2 mg (n = 47). Baseline characteristics were similar between the two groups. Desmopressin add-on group was significantly superior to placebo in terms of the change from baseline in the mean number of nocturia episodes (-1.13 ± 0.92 vs -0.68 ± 0.79, p = 0.034) change in nocturnal urine volume (p <0.001), change in total International Prostate Symptom Score (p = 0.041), change in nocturnal polyuria index (p = 0.001), change in International Consultation on Incontinence Questionnaire-Nocturia (p = 0.001), and willingness to continue (p = 0.025). The incidence of adverse events in desmopressin add-on group was similar to that in placebo group. Most adverse events were mild.

Desmopressin add-on therapy in men aged 40-65 years with persistent nocturia on alpha-blocker monotherapy for LUTS is effective and well tolerated.

The Journal of urology. 2016 Sep 10 [Epub ahead of print]

Joon Chul Kim, Kang Jun Cho, Jeong Gu Lee, Ju Tae Seo, Duk Yoon Kim, Seung-June Oh, Kyu-Sung Lee, Myung-Soo Choo, Jeong Zoo Lee

Department of Urology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea., Department of Urology, College of Medicine, Korea University, Seoul, Korea., Department of Urology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea., Department of Urology, Daegu Catholic University, College of Medicine, Daegu, Korea., Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea., Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea., Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Department of Urology, Pusan National University, School of Medicine, Busan, Korea. Electronic address: .