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Desmopressin Melt Therapy in Patients With Nocturnal Polyuria: a Pharmacokinetic/Dynamic Study

Phase 4
Completed
Conditions
Nocturnal Polyuria
Interventions
Registration Number
NCT01435083
Lead Sponsor
University Hospital, Ghent
Brief Summary

The objective of this study is to find out what the pharmacokinetic/dynamic (PK/PD) characteristics of desmopressin melt are in nocturia patients (compared to healthy volunteers and children). The main questions the investigators want to answer are:

* Are differences related to the pathophysiological factors involved in nocturia?

* Are there age/gender/size differences?

* Can the investigators identify patients who are likely to develop hyponatraemia?

* Can the investigators individualize treatment and reduce risk for hyponatraemia?

Day 1:

* Patient is being hospitalized in the morning

* General anamnesis and clinical examination

* Uroflow and residue measurements (3x)

* Sober blood sample, to determine plasma concentrations of Na+, Cl-, osmolality and creatinin

Day 1-2:

- In the evening at 20h:

* start (with empty bladder!) 24h miction-incontinence-residue registration: urine collections every 3 hours (every portion of urine within a period of 3 hours must be collected in the same collection device), with: registration of volumes and measurement urinary concentrations of Na+, Cl-, osmolality and creatinin

* Measurement of blood pressure during 24h

Day 2-3:

* In the evening at 19h (day 2): drink 15mL/kg water

* At 20h: take desmopressin melt 120µg + start:

* 24h miction-incontinence-residue registration: registration of volumes and measurement urinary concentrations of Na+, Cl-, osmolality and creatinin (U1-U7)

* Measurement of blood pressure during 24h

* Collection of urine:U1 at 19h, U2 at 20h, together with intake of first desmopressin melt, U3 at 21h = 1h after desmopressin melt intake, U4 at 22h = 2 after desmopressin melt intake,U5 at 23h = 3h after desmopressin melt intake, U6 at 2h (day 3) = 6h after desmopressin melt intake, U7 at 8h = 12h after desmopressin melt intake

* Blood samples for blood levels of desmopressin: 1h, 2h, 3h, 6h after desmopressin melt intake, 12h after desmopressin melt intake + plasma concentrations of Na+, Cl-, osmolality and creatinin (safety profile)

* At 8h in the morning (day 3): drink 15mL/kg water + collection of urine per hour during 3h with measurement of urinary concentrations of Na+, Cl-, osmolality and creatinin: U8 at 9h, U9 at 10h, U10 at 11h

* Patient can go home on day 3, unless he is at high risk for side effects, high-risk patients are hospitalized for 7 days

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
50
Inclusion Criteria
  • written informed consent prior to the performance of any study-related activity
  • patients, men and woman, 18 years and older, with nocturnal polyuria, resulting in nocturia (2 voids or more at night) and/or nocturnal incontinence.
Read More
Exclusion Criteria
  • hypersensitivity/anaphylactic reaction on desmopressin or one of the other substances
  • pregnancy
  • genitourinary tract pathology (infection, tumor,...)
  • urolithiasis
  • suspicion or evidence of cardiac failure
  • moderate to severe renal insufficiency (creatinin clearance < 50 ml/min)
  • psychogenic or habitual polydipsia
  • hyponatraemia or predisposition for hyponatraemia
  • diabetes insipidus
  • syndrome of inadequate ADH production
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
nocturnal polyuria patient with desmopressin MELTDesmopressin-
Primary Outcome Measures
NameTimeMethod
Pharmacokinetic and dynamic evaluation of desmopressin melt for treatment of nocturnal polyuria in adultshospitalisation of 3 days of which 15h specific for primary outcome measurements

* blood analysis for plasma concentration of desmopressin: 1h, 2h, 3h, 6h and 12h after drug intake

* urine analysis for urinary concentration of sodium, potassium, creatinin and osmolality:

* after water load with 15ml/kg body weight (evening day 2): the moment of drug intake, 1h, 2h, 3h, 6h and 12h after drug intake

* after water load with 15ml/kg body weight (morning day 3): 1h, 2h, 3h after water load

Secondary Outcome Measures
NameTimeMethod
24h miction-incontinence-residue registration: urine collections every 3 hours2x 24h: day 1 19h - day 2 19h ; day 2 20h - day 3 20h

24h miction-incontinence-residu registration: urine collections every 3 hours (every portion of urine within a period of 3 hours must be collected in the same collection device), with:

* Registration of volumes

* Measurement urinary concentrations of Na+, Cl-, osmolality and creatinin

Measurement of blood pressure during 24h2x 24h: day 1 19h - day 2 19h ; day 2 20h - day 3 20h

Trial Locations

Locations (1)

University Hospital Ghent

🇧🇪

Ghent, Belgium

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