University of Bristol, Bristol, UK.
Bristol Urological Institute, Southmead Hospital, Bristol, UK.
Expert Rev Clin Pharmacol. 2021 Aug;14(8):939-954. doi: 10.1080/17512433.2021.1931122. Epub 2021 Jun 14.
: Desmopressin was widely used to treat nocturnal polyuria in adults under the age of 65 due to the well-established risk of hyponatremia. Since the prevalence of nocturia increases with age, and with an aging population, those most affected were excluded from treatment. Recently, a new lower dose sublingual tablet formulation that optimizes the balance between efficacy and tolerability has been licensed for symptomatic treatment of nocturia due to idiopathic nocturnal polyuria in adults of any age, with the caveat of regular serum monitoring for those over 65. This newer formulation aims to achieve the same clinical outcomes as previous formulations while reducing the risk of hyponatremia.: This review will look at the pharmacology of the newly formulated desmopressin and examine the results of the clinical trials that would support its treatment of adult nocturia with idiopathic nocturnal polyuria.: When reporting on the clinical efficacy of desmopressin on nocturia, it is important for clinical trials to publish their complete data on nocturnal and 24-hour urine voided volumes. Further research examining the physiological reasoning behind this gender-specific dosing for desmopressin and the optimal recommended treatment duration of desmopressin for those over 65 is needed.
去氨加压素被广泛用于治疗 65 岁以下成人的夜间多尿症，因为低钠血症的风险已得到充分证实。由于夜尿症的患病率随年龄增长而增加，且人口老龄化，因此大多数受影响的人被排除在治疗之外。最近，一种新的低剂量舌下片剂配方已获得许可，用于治疗任何年龄的特发性夜间多尿症引起的症状性夜尿症，其 caveat 是 65 岁以上患者需要定期进行血清监测。这种新配方旨在实现与以前配方相同的临床效果，同时降低低钠血症的风险。
这篇综述将探讨新配方去氨加压素的药理学，并研究支持其治疗特发性夜间多尿症成人夜尿症的临床试验结果。
在报告去氨加压素对夜尿症的临床疗效时，临床试验公布夜间和 24 小时尿液排空量的完整数据非常重要。需要进一步研究去氨加压素这种针对特定性别的剂量以及对于 65 岁以上患者去氨加压素的最佳推荐治疗时间背后的生理原理。
