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Desmopressin, as a “designer‐drug,” in the treatment of overactive bladder syndrome
Author(s) -
Hashim Hashim,
Malmberg Lars,
GraugaardJensen Charlotte,
Abrams Paul
Publication year - 2009
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.20613
Subject(s) - medicine , desmopressin , overactive bladder , placebo , hyponatremia , adverse effect , oxybutynin , urology , tolterodine , clinical endpoint , clinical trial , anesthesia , alternative medicine , pathology
Aims This study looked at whether oral desmopressin, by decreasing kidney urine production, would prolong bladder filling‐time thereby increasing the time to reach maximum capacity, thus reducing overactive bladder (OAB) symptoms, and providing an alternative method of treatment to OAB sufferers. Methods An investigator‐initiated, 2‐week, multi‐national, multi‐centre, “proof‐of‐concept,” phase IIb, double‐blind, placebo‐controlled, prospective, randomized, cross‐over study was conducted using 0.2 mg of oral desmopressin in adults suffering with OAB. Patients were included in the trial period if they had ≥4 voids in the first 8‐hr of the day after rising, excluding the first morning void. The primary endpoint was evaluation of effectiveness of desmopressin in increasing the time to the first OAB symptom episodes during the first 8‐hr following treatment. Results Time to first void was 8‐min later on the drug than on placebo ( P = 0.27). However, the drug led to one less void (3.2 vs. 4.2) in the same period ( P < 0.001). There was an increase in the time to first urgency episode with a decrease in the number of urgency episodes in the drug days compared to placebo ( P < 0.003). There was a subjective improvement in frequency and urgency and overall quality‐of‐life as measured by the ICIQ‐OAB. Twenty‐seven people reported adverse events which were all mild, headache being the commonest and no hyponatremia was recorded. Conclusions Antidiuresis, using oral desmopressin tablets, is a novel, feasible and safe (short‐term basis) method of treatment for adults with OAB, and could be considered in the armamentarium of drugs available for the treatment of OAB. Neurourol. Urodynam. 28:40–46, 2009. © 2008 Wiley‐Liss, Inc.