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Nocturnal polyuria is frequently found in patients with nocturia irrespective of co-existing lower urinary tract symptoms
Bjarke M. Klein, PhD1, Jeffrey P. Weiss, MD2 Brian Marks MD2.
1Ferring International Pharmascience Center, Copenhagen, Denmark, 2SUNY Downstate Medical School, Brooklyn, NY, USA.

Background: Among patients referred for treatment of nocturia, some have underlying components of overactive bladder (OAB), benign prostatic hyperplasia (BPH) or both. It is of interest to determine the frequency of these conditions and how patients with nocturia and OAB/BPH compare to those without these conditions in terms of baseline characteristics that may affect treatment success. Here we analyze the characteristics of patients suffering from nocturia, with or without additional OAB/BPH treatment, who were enrolled in a large phase III trial of desmopressin orally disintegrating tablets vs. placebo.
Methods: Adult patients with an average of ≥2 voids per night (determined using a 3-day voiding frequency diary) were recruited from 83 study centers in the USA and Canada.
The following data was collected: Sex, age, BMI, presence of nocturnal polyuria (NP, night-time/24-h volume ≥33%) # voids (total, nocturnal and daytime) and volume (total, nocturnal and daytime).
Data for the following 5 groups was summarized: All randomized (n=799), those with (n=143) and without (n=656) concomitant treatment (Con Tx) for OAB and/or BPH, those with Con Tx for OAB (n=69), and those with Con Tx for BPH (n=89). Definition of OAB and BPH was based on presence of Con Tx as this was considered the most reliable indicator of active disease.
Results: Approximately 20% of patients (143/799) had Con Tx for OAB and/or BPH. NP was present in the vast majority of patients across all groups (range 88%-92%). There were no clinically significant differences between the groups for any baseline parameter (for range of means, see Table 1). Exploratory analyses suggested that desmopressin as an add-on treatment in OAB/BPH treated patients reduces nocturia to the same extent as in patients without either condition.
Table 1: Baseline characteristics in nocturia patients; range of means in all randomized (n=799) and 4 subgroups (+/- OAB and/or BPH; +OAB; +BPH)

Range of means across all 5 groups
Age (years)61-70
BMI kg/m228-30
Voids (#)
Total10.7-11.2
Nocturnal3.3-3.6
Daytime7.4-7.6
Volume (ml)
Total1679-1776
Nocturnal814-858
Daytime820-935

Conclusions
In this broad cohort of patients referred for treatment of nocturia, subgroup analyses indicated that nocturia patients with and without OAB/BPH are comparable with respect to prevalence of NP and voiding pattern (# and volume), indicating that the common cause for nocturia is NP. Exploratory analyses also suggested a comparable effect of desmopressin orally disintegrating tablets in these subgroups.
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