Desai Sethi Urology Institute, University of Miami Miller School of Medicine
Introduction: Nocturia is a bothersome lower urinary tract symptom that can be treated with a variety of medications depending on age, sex, and accompanying diagnoses. In the present study, we evaluate global trends in the pharmacotherapy of nocturia from 2016 to 2021. Methods: We queried TriNetX, a global federated research network, to identify patients aged =18 years diagnosed with nocturia by ICD-10 code between January 2016 and December 2021. The primary outcome was medication use after diagnosis. Medications analyzed included alpha-blockers, oxybutynin, other anticholinergics, mirabegron, finasteride, dutasteride, desmopressin, tadalafil, melatonin, and botulinum toxin. Treatment rates were analyzed by year (2016–2021) as well as by age bracket. Results: A total of 508,126 adults with nocturia were identified. The average age was 63.2 ± 13.9 years. From 2016 to 2021, the number of nocturia cases increased from 69,868 to 162,306 (average of 18,488 new cases per year) (Fig A). Females made up 29.9% of the study population (Fig B). Of the males, 33.7% were diagnosed with benign prostatic hyperplasia. Alpha-blockers and anticholinergics were the most commonly used medications for patients aged 40 years and older, followed initially by oxybutynin, and then by finasteride at ages 70 years and older. All medications analyzed experienced a decline in use throughout the study period, though nearly all experienced increased use rates with increasing age, with the exception of desmopressin and botulinum toxin (Fig C-D). Conclusions: From 2016 to 2021, rates of pharmacotherapy for nocturia declined despite increasing case count. This suggests that nocturia may be pharmacologically undertreated in the general population. SOURCE OF Funding: This project was supported by the Clinical Research Center of University Hospitals Cleveland Medical Center (UHCMC) and the Case Western Reserve University Clinical and Translational Science Collaborative (CTSC) 4UL1TR000439.
