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低剂量去氨加压素口服崩解片治疗女性夜间多尿症的疗效和安全性:多中心、随机、双盲、安慰剂对照、平行分组研究结果。

Efficacy and safety of low dose desmopressin orally disintegrating tablet in women with nocturia: results of a multicenter, randomized, double-blind, placebo controlled, parallel group study.

机构信息

NorthShore University HealthSystem, Evanston, Illinois 60201, USA.

出版信息

J Urol. 2013 Sep;190(3):958-64. doi: 10.1016/j.juro.2013.02.037. Epub 2013 Feb 20.

Abstract

PURPOSE

Previous studies suggest a lower dose of desmopressin orally disintegrating tablet may be effective in females compared to males with nocturia. We confirm the efficacy and safety of 25 μg desmopressin orally disintegrating tablet compared to placebo in female patients.

MATERIALS AND METHODS

In this 3-month, randomized, double-blind, parallel group study 25 μg desmopressin once daily was compared to placebo in women with nocturia (2 or more nocturnal voids). The co-primary efficacy end points were change from baseline in mean number of nocturnal voids and proportion of patients achieving at least a 33% reduction from baseline in the mean number of nocturnal voids (33% responders).

RESULTS

The full analysis set comprised 261 patients (age range 19 to 87 years). Desmopressin significantly reduced the mean number of nocturnal voids and increased the odds of a 33% or greater response compared to placebo during 3 months, assessed by longitudinal analysis (-0.22, p = 0.028 and OR 1.85, p = 0.006, respectively). Desmopressin increased the mean time to first nocturnal void by 49 minutes compared to placebo at 3 months (p = 0.003). The response to desmopressin was seen by week 1 of treatment and was sustained throughout the trial. Significant increases in health related quality of life and sleep quality were observed compared to placebo. Desmopressin was well tolerated. Serum sodium levels remained greater than 125 mmol/L throughout the trial and 3 transient decreases to less than 130 mmol/L were recorded.

CONCLUSIONS

At a dose of 25 μg, desmopressin orally disintegrating tablet is an effective and well tolerated treatment for women with nocturia. Treatment provides rapid and sustained improvement in nocturia and quality of life.

摘要

目的

先前的研究表明,与男性相比,女性夜间多尿症患者口服崩解片的较低剂量可能更有效。我们证实了 25μg 去氨加压素口服崩解片与安慰剂相比在女性患者中的疗效和安全性。

材料和方法

在这项为期 3 个月、随机、双盲、平行组研究中,每日一次给予 25μg 去氨加压素,与安慰剂比较,治疗夜间多尿症(2 次或更多夜间排尿)的女性患者。主要疗效终点是从基线平均夜间排尿次数的变化和至少从基线平均夜间排尿次数减少 33%的患者比例(33%应答者)。

结果

全分析集包括 261 名患者(年龄 19-87 岁)。与安慰剂相比,去氨加压素在 3 个月内显著减少了平均夜间排尿次数,并增加了 33%或更多应答的可能性,通过纵向分析评估(-0.22,p=0.028 和 OR 1.85,p=0.006)。与安慰剂相比,去氨加压素在 3 个月时将首次夜间排尿的平均时间延长了 49 分钟(p=0.003)。在治疗的第 1 周就观察到了去氨加压素的反应,并在整个试验过程中持续存在。与安慰剂相比,观察到健康相关生活质量和睡眠质量显著提高。去氨加压素耐受良好。整个试验过程中血清钠水平均大于 125mmol/L,记录到 3 次短暂降至小于 130mmol/L。

结论

在 25μg 剂量下,去氨加压素口服崩解片是治疗夜间多尿症女性患者的有效且耐受良好的治疗方法。治疗可快速且持续改善夜间多尿症和生活质量。

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