Efficacy and safety of desmopressin in nocturia and nocturnal polyuria control of neurological patients: A systematic review and meta‐analysis

Purpose Evidence on the efficacy of desmopressin in nocturia in patients with neurological diseases is still very limited except for multiple sclerosis (MS). Our aim was to evaluate the efficacy and safety of desmopressin treatment on nocturia in patients with underlying neurological diseases. Metho...

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Published in:Neurourology and urodynamics 2024-01, Vol.43 (1), p.167-182
Main Authors: Hajebrahimi, Sakineh, Darvishi, Afra, HajEbrahimi, Reyhaneh, Asadi, Nazli, Jafari Shendi, Zahra, Asiaban, Negar, Naseri, Amirreza, Sadeghi‐Ghyassi, Fatemeh, Mostafaei, Hadi, Salehi‐Pourmehr, Hanieh
Format: Article
Language:English
Subjects:
Antidiuretic Agents - adverse effects
Argipressin
Atrophy
Clinical trials
Deamino Arginine Vasopressin - adverse effects
Desmopressin
Female
Humans
Male
Meta-analysis
Movement disorders
Multiple sclerosis
Multiple Sclerosis - drug therapy
Myelodysplastic syndrome
Neurodegenerative diseases
Neurological diseases
Nocturia
Nocturia - drug therapy
Nocturia - etiology
Parkinson's disease
Polyuria
Safety
Spinal cord injuries
Statistics
systematic review
Treatment Outcome
Urination
Vasopressin
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Summary:Purpose Evidence on the efficacy of desmopressin in nocturia in patients with neurological diseases is still very limited except for multiple sclerosis (MS). Our aim was to evaluate the efficacy and safety of desmopressin treatment on nocturia in patients with underlying neurological diseases. Methods Studies were identified by electronic search of PubMed, Embase, Cochrane, CINAHL, and Google Scholar databases. Studies were considered if they provided information on the effectiveness and safety of desmopressin (1‐desamino‐8‐d‐arginine vasopressin, or DDAVP) in the treatment of nocturia and their participants had acquired neurological pathology. Two researchers independently extracted the articles using specified datasets, such as quality‐of‐study indicators. Statistical meta‐analysis was carried out using Review Manager (RevMan) 5.4 statistical software (Cochrane Collaboration). Results Of a total of 1042 articles in the initial search, 14 studies were included. Most of the published papers were related to MS (n = 7), two were on spinal cord injury, and other conditions were neural tube defect, myelodysplasia, Parkinson's disease, stroke, and multiple system atrophy. Overall, a total of 200 patients (mostly females) were enrolled. Thirteen studies evaluated the intranasal formulation of desmopressin and one study evaluated oral desmopressin. A significant decrease in nocturia episodes was reported in seven studies evaluating this topic. An increase in the maximum hours of uninterrupted sleep was reported in the three studies in which this outcome was assessed. A significant reduction in the volume of nocturnal incontinence was found in one study. Three studies were eligible to include in the meta‐analysis. The results showed that desmopressin compared to placebo, significantly reduced nighttime urination (mean difference: −0.75, 95% CI: −1.10 to −0.41; p 
ISSN:0733-2467
1520-6777
DOI:10.1002/nau.25291