Desmopressin 50mg effectively reduces nocturia in older men with higher muscle mass

Nocturia, characterized by waking to urinate multiple times at night, significantly impairs sleep quality and overall Quality of Life in older men. A common cause is nocturnal polyuria, where excessive urine is produced during sleep. Current management strategies often fall short, leading to persistent symptoms. Desmopressin, a synthetic analog of vasopressin, acts on renal V2 receptors to reduce urine production, offering a potential therapeutic avenue. However, its efficacy can vary, and identifying predictive factors for treatment success is crucial for optimizing patient selection and improving outcomes.

This study administered Desmopressin 50mg daily for 12 weeks to 49 patients (mean age 76.3 ± 7.3 years) experiencing persistent nocturia due to nocturnal polyuria. The primary objective was to assess the efficacy of desmopressin and identify independent factors influencing its success. Efficacy was evaluated using validated questionnaires including the International Prostate Symptom Score (IPSS), Quality of Life index, Overactive Bladder Symptom Score (OABSS), and the Athens Insomnia Scale (AIS). Baseline characteristics, including body composition via baseline measurement of muscle mass, were analyzed to determine predictive factors.

After 12 weeks of Desmopressin 50mg treatment, significant improvements were observed in key patient-reported outcomes. The International Prostate Symptom Score (IPSS) improved significantly, indicating a reduction in overall urinary symptoms. Similarly, the Quality of Life index also improved significantly, reflecting a better patient experience. However, not all symptom scores showed improvement; the Overactive Bladder Symptom Score (OABSS) and the Athens Insomnia Scale (AIS) did not show significant improvement. This suggests a specific impact on nocturia and general well-being rather than broader bladder or sleep issues. > Importantly, only muscle mass at the baseline measurement was identified as a factor predictive of desmopressin's efficacy, suggesting a potential physiological link between body composition and treatment response.