Saviour drug for urine over-production

You might think that having to keep getting up to use the bathroom in the night is only a problem that kids face before growing out of it. Or perhaps that it won’t affect you until you’re a lot older. However, it affects a staggering amount of people of all ages and can have a seriously negative impact on your mental and physical well-being.

Check out the announcement today from Ferring Pharmaceuticals on the TGA approval of their new drug to combat all those nighttime trips to the bathroom.

Many Australian adults living with the complex medical condition, nocturnal polyuria, may benefit from the Therapeutic Goods Administration (TGA) approval of a new treatment that addresses night-time urine over-production.

NOCDURNA® (desmopressin) – a once-daily low-dose, gender-specific sublingual wafer – is Australia’s first and only medication to be indicated for the treatment of nocturia due to idiopathic nocturnal polyuria in adults (confirmed by bladder diary with >33% of daily urine output passed overnight) who awaken two or more times each night to void and have not responded to lifestyle measures.

According to Dr Jenny King, Head, Department of Urogynaecology, Westmead Hospital, Sydney, bothersome nocturia, or waking from sleep to pass urine, is a complex condition often with several contributing factors. Elevated nocturnal urine production may be responsible for up to 88 per cent of cases when there is an absence of daytime symptoms.

“Nocturia is a common urological cause of sleep disturbance across all ages. Nocturnal polyuria results from an abnormally large volume of urine production during sleep, which may be associated with low levels of arginine vasopressin, the antidiuretic hormone regulating water resorption by the kidneys, and thereby, concentration of urine. For the first time, we have a treatment specifically directed at idiopathic nocturnal polyuria among adults.

“The TGA approval of NOCDURNA® is a significant milestone for a large number of Australians who previously had limited treatment options. Now we need to raise awareness that this often-overlooked condition can be treated,” said Dr King.

“Trials found that NOCDURNA® reduced the number of nocturnal voids, lengthened the first uninterrupted sleep period and improved quality of life. NOCDURNA® is generally well tolerated with a recognised and well-understood clinically relevant risk of desmopressin therapy, hyponatraemia, which is managed with sodium monitoring.

“NOCDURNA® doses are considerably lower than the MINIRIN® (desmopressin) doses used for the treatment of primary nocturnal enuresis (PNE) in children. NOCDURNA® is available in low-dose, gender-specific sublingual wafers, enabling a personalised medicine approach for men and women,” Dr King said.

According to Associate Professor Bill Lynch, urologist, Macquarie University, Sydney, nocturia has a profound impact on quality of life, comparable to conditions such as diabetes, hypertension and angina.

“Night-time urine over-production interrupts normal sleep, impacting physical, mental and emotional health and wellbeing, and reducing daytime productivity and quality of life.

“Many studies associate nocturia with increases in sleep disorders, daytime fatigue, poorer quality sleep, and problems with perception and balance, which can sometimes increase the risk of falls and injuries. Nocturia is also a predictor of mortality, with higher mortality risk associated with increased nightly polyuria,” said A/Prof Lynch.

“It is important that GPs and physios are aware of this condition, and recognise the importance of referring to a specialist urologist, uro-gynaecologist, gynaecologist or geriatrician for treatment.

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