Abstract：
OBJECTIVE: 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 < 0.00001). The rate of adverse events ranged from 0% to 68.42%. The critical appraisal results for all trials showed that most of the studies had low or moderate quality.
CONCLUSIONS: Our results emphasized desmopressin\'s safety and efficacy in reducing nocturia episodes, with transient adverse effects on neurological patients. However, the data were achieved from low or medium-quality trials, and further well-designed randomized controlled trials are needed.
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 < 0.00001). The rate of adverse events ranged from 0% to 68.42%. The critical appraisal results for all trials showed that most of the studies had low or moderate quality.
CONCLUSIONS: Our results emphasized desmopressin\'s safety and efficacy in reducing nocturia episodes, with transient adverse effects on neurological patients. However, the data were achieved from low or medium-quality trials, and further well-designed randomized controlled trials are needed.
摘要：
目的：除多发性硬化症（MS）外，去氨加压素对神经系统疾病患者夜尿症的疗效的证据仍然非常有限。我们的目的是评估去氨加压素治疗基础神经系统疾病患者夜尿症的疗效和安全性。
方法：通过电子搜索PubMed，Embase,科克伦,CINAHL,和谷歌学者数据库。如果研究提供了去氨加压素（1-去氨基-8-d-精氨酸加压素，或DDAVP）治疗夜尿症，其参与者获得了神经系统病理学。两名研究人员使用指定的数据集独立提取文章，如研究质量指标。使用ReviewManager（RevMan）5.4统计软件（CochraneCollaboration）进行统计荟萃分析。
结果：在初始搜索的共1042篇文章中，包括14项研究。发表的论文大多与MS有关（n=7），两个是脊髓损伤，其他情况是神经管缺陷，骨髓增生异常,帕金森病,中风,和多系统萎缩。总的来说,共纳入200例患者(多数为女性).13项研究评估了去氨加压素的鼻内制剂，一项研究评估了口服去氨加压素。在评估该主题的七项研究中，夜尿症发作显着减少。在评估该结果的三项研究中，报告了不间断睡眠的最大时间增加。在一项研究中发现夜间失禁的体积显着减少。三项研究有资格纳入荟萃分析。结果表明，去氨加压素与安慰剂相比，夜间排尿显着减少（平均差异：-0.75，95％CI：-1.10至-0.41；p<0.00001）。不良事件发生率为0%~68.42%。所有试验的关键评估结果表明，大多数研究质量低或中等。
结论：我们的结果强调了去氨加压素在减少夜尿症发作方面的安全性和有效性，对神经系统患者有短暂的不良反应。然而,数据来自低质量或中等质量的试验，需要进一步精心设计的随机对照试验.
方法：通过电子搜索PubMed，Embase,科克伦,CINAHL,和谷歌学者数据库。如果研究提供了去氨加压素（1-去氨基-8-d-精氨酸加压素，或DDAVP）治疗夜尿症，其参与者获得了神经系统病理学。两名研究人员使用指定的数据集独立提取文章，如研究质量指标。使用ReviewManager（RevMan）5.4统计软件（CochraneCollaboration）进行统计荟萃分析。
结果：在初始搜索的共1042篇文章中，包括14项研究。发表的论文大多与MS有关（n=7），两个是脊髓损伤，其他情况是神经管缺陷，骨髓增生异常,帕金森病,中风,和多系统萎缩。总的来说,共纳入200例患者(多数为女性).13项研究评估了去氨加压素的鼻内制剂，一项研究评估了口服去氨加压素。在评估该主题的七项研究中，夜尿症发作显着减少。在评估该结果的三项研究中，报告了不间断睡眠的最大时间增加。在一项研究中发现夜间失禁的体积显着减少。三项研究有资格纳入荟萃分析。结果表明，去氨加压素与安慰剂相比，夜间排尿显着减少（平均差异：-0.75，95％CI：-1.10至-0.41；p<0.00001）。不良事件发生率为0%~68.42%。所有试验的关键评估结果表明，大多数研究质量低或中等。
结论：我们的结果强调了去氨加压素在减少夜尿症发作方面的安全性和有效性，对神经系统患者有短暂的不良反应。然而,数据来自低质量或中等质量的试验，需要进一步精心设计的随机对照试验.
