2014.05.16 11:04
A recent phase III trial demonstrated significant increases of FUSP in patients treated with disintegrating sublingual tablets vs placebo. The data reviewed in this study will be particularly valuable for urologists formulating pharmacologic management strategies for men with nocturia. – Matthew Resnick, MD Few studies have looked specifically at parameters other than nocturnal voids, such as sleep latency, first undisturbed sleep period (FUSP), and total sleep time, including their clinical relevance to patient well-being. Lifestyle modifications, such as voiding before bedtime, limiting caffeine and alcohol, and adjusting medication timing, may be initially effective in mild cases of nocturia. Statistically significant reductions in voiding have been reported with antimuscarinic agents and alpha-blockers as initial therapy, but these reductions generally are not clinically relevant. The antidiuretic therapy desmopressin acetate, a selective vasopressin receptor 2 agonist, is effective in adults with nocturia associated with nocturnal polyuria; however, hyponatremia can occur. The newest formulation-desmopressin orally disintegrating sublingual tablet (ODST)-has greater bioavailability; thus, lower doses can be used, potentially reducing hyponatremia risk. A phase 3 study demonstrated statistically significant reductions in nocturnal voids for desmopressin ODST 50 and 100 μg versus placebo (-1.18 and -1.43 vs. -0.86; P = 0.02 and P < 0.0001, respectively) in patients with nocturia. Treatment was well-tolerated, and low-dose desmopressin ODST was associated with statistically significant increases in duration of FUSP. Development of a validated composite endpoint may help clinicians identify and compare strategies for treating nocturia. |
This is a good news for someone like me who has suffered a great deal from nocturia for many years.
This is a report of phase 3 trial so that the ADH prep used in this study may become available soon hopefully.
As a cardiologist, I have encountered many patients who experienced syncope, near syncope or lightheadedness
and falls from the alpha blockers that are prescribed by their urologists and are causing orthostatic hypotension.
I myself was one of them and have avoided those alpha blockers for years ever since the syncopal attack.
Those are Flomax(tamsulosin), Cardura(doxazosin), and Hytrin(terazosin).