An evaluation of the pharmacotherapy for interstitial cystitis

Abstract

Interstitial cystitis (IC) and bladder pain syndrome (BPS) are chronic conditions that can be debilitating for patients. There is no consensus as to their etiology, and there are many proposed treatment algorithms. Oftentimes multimodal therapy, such as combining behavioral modification and physical therapy alongside pharmacotherapies, will be utilized. With the various treatment options available to patients and providers, there is an ever-growing need to implement evidence-based therapies. Areas covered: The authors explore the different pharmacotherapies as commonly recommended in the American Urological Association (AUA) and European Association of Urology (EAU) multitiered guidelines for IC/BPS treatment as well as other investigational therapies. Pharmacotherapies targeting bladder, pelvic, and/or systemic factors in the overall treatment of IC/BPS are discussed with a particular focus on evidence-based guideline therapies. This article also looks at emerging therapies of interest. Expert opinion: IC/BPS is a syndrome that requires a multimodal approach, including clinical phenotyping and directed therapy based on the patient's symptoms. The AUA and EAU provide guidelines for practitioners to follow, but adequate treatment requires the therapy to be targeted toward the patient's phenotypic domain.

Is there an effective therapy of interstitial cystitis/bladder pain syndrome?

“…PPS is an orally administered agent, US-FDA approved for IC/BPS. Although with promising initial results, recent data question its efficacy in IC/BPS treatment [16]. Immunosuppressive agents, such as cyclosporine A (CyA), are underway for the IC/BPS treatment.…”

“…Immunosuppressive agents, such as cyclosporine A (CyA), are underway for the IC/BPS treatment. CyA's use is further supported by measuring urine and blood 'biomarkers' during treatment [16]. Although promising with initial better results than PPS and recommended by the AUA guidelines, it is not currently approved by the US-FDA.…”

An update on treatment options for interstitial cystitis

“…Although the growing body of evidence about the IC/BPS clinical presentation and pathophysiology, the real etiopathogenesis is not completely understood as well as the role of the different cystoscopic/histologic presentation. These factors limit the available evidence-based treatment options, that are of paramount importance to maximize treatment outcomes since the early stages of the disease [ 5 , 14 ]. Noteworthy, the early diagnosis has a key role in the syndrome [ 15 ], that is a pain syndrome and can determine a pelvic cross-organ sensitization worsening symptoms and hardening management and resolution.…”

Effectiveness of neuromuscular electrical stimulation for interstitial cystitis: a protocol of systematic review and meta-analysis

“…The etiology of IC remains poorly understood [9]. Despite several therapies are reported to manage IC, none of them can effectively treat this condition [10][11]. Thus, it is very urgent to nd potential candidates.…”