Desmopressin orally disintegrating tablet in Japanese patients with central diabetes insipidus: a retrospective study of switching from intranasal desmopressin.
Central diabetes insipidus (CDI) is a rare disease characterized by polyuria and polydipsia. Patients with CDI have been successfully treated with desmopressin administered either by intranasal instillation or oral tablets. Recently, a desmopressin orally disintegrating tablet (ODT) was approved as the first oral desmopressin tablet for CDI treatment in Japan. We conducted a retrospective single-center study of 15 Japanese CDI patients treated with desmopressin ODT therapy, which aimed to evaluate the efficacy and safety of switching to desmopressin ODT and to analyze the clinical factors that affect the desmopressin ODT dose in Japanese patients. The daily mean dose of desmopressin ODT was 104 ± 46.30 μg and the mean ratio of oral to nasal desmopressin dose was 17.0 ± 7.6, both of which are considerably smaller than those of previous dose-titration study. Moreover, the nasal spray group needed significantly smaller ratios of nasal to oral desmopressin than the nasal drop group (11.7 ± 6.5 vs 21.0 ± 5.5, p = 0.02). The ratio of oral to nasal desmopressin dose had a significant inverse correlation with the required nasal desmopressin dose. Multiple regression analysis demonstrated the ratios of nasal to oral desmopressin dose depended on intranasal formulations. In conclusion, desmopressin ODT was safe and effective in the treatment of Japanese adult CDI patients. When switching to ODT, we should care about the possibility that patients require smaller ODT doses than what was initially expected based on previously published data and also nasal formulations in terms of their differences of expected switching ratio.
Department of Diabetes and Endocrinology, Osaka Red Cross Hospital, Osaka 543-0027, Japan.
Takaaki
T
Murakami
Tomonobu
T
Hatoko
Takuo
T
Nambu
Yuki
Y
Matsuda
Koji
K
Matsuo
Shin
S
Yonemitsu
Seiji
S
Muro
Shogo
S
Oki
D000281:Administration, Intranasal; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050034:Antidiuretic Agents / Q000008:administration & dosage*; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage*; D020790:Diabetes Insipidus, Neurogenic / Q000188:drug therapy*; D057915:Drug Substitution; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013607:Tablets
D050034:Antidiuretic Agents; D013607:Tablets; D003894:Deamino Arginine Vasopressin