A Danish population‐based cohort study of desmopressin use in adults with nocturia or nocturnal enuresis

• Published in: Lower urinary tract symptoms 2019-04, Vol.11 (2), p.O121-O126
• Main Authors: Juul, Kristian Vinter, Schrøder, Marie Krarup, Mahler, Birgitte, Rittig, Søren, Nørgaard, Jens Peter
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adults; Age; Age Factors; Aged; Aged, 80 and over; Antidiuretic Agents - therapeutic use; Cohort analysis; Deamino Arginine Vasopressin - therapeutic use; Denmark; desmopressin; Drug Prescriptions - statistics & numerical data; Female; Humans; Male; Middle Aged; nocturia; Nocturia - drug therapy; nocturnal enuresis; Nocturnal Enuresis - drug therapy; Patients; pharmacoepidemiology; Population-based studies; Prescriptions; Registries; Sex Factors; Young Adult
• ISSN: 1757-5664; 1757-5672
• DOI: 10.1111/luts.12229

Objective This study investigated how desmopressin is prescribed to adults in Denmark. Methods All adult users of desmopressin over an 8‐year period were identified from the Danish National Prescription Registry. Adult patients with nocturia or nocturnal enuresis (NE) were identified by indication codes for “frequent nocturnal voiding” or “involuntary nocturnal voiding”, respectively. Patient demographics, desmopressin formulation and dose, and concomitant medication were investigated. Results In all, 13 871 adults with nocturia and 2872 adults with chronic (i.e. >10 prescriptions) NE were given 102 547 and 43 712 desmopressin prescriptions, respectively. Across the entire patient cohort, 57% were women and mean patient age was 62 years. Over 40% of prescriptions were to elderly patients (≥65 years), and desmopressin use for adult enuresis increased with age. Orally disintegrating tablets were the most frequently used formulation (57%–65% of prescriptions), and a greater proportion of women than men used low‐dose desmopressin (60 μg). Concomitant use of painkillers (opioids: 18%–26.7% of prescriptions; non‐steroidal anti‐inflammatory drugs: 14.2%–16.4% of prescriptions) and antidepressants (14.4%–18.1% of prescriptions) was common in both conditions, and 5.4%–9.2% of concomitant prescriptions were for overactive bladder medications. Conclusions This study provides insights into desmopressin use among Danish adults. Nearly half the prescriptions were to patients aged ≥65 years, despite historical manufacturer recommendations that desmopressin be restricted to patients