Long-Term Outcome of Patients With Interstitial Cystitis Treated With Low Dose Cyclosporine A

Abstract

Cyclosporine A treatment was safe and effective in treating interstitial cystitis. The achieved therapeutic effect was maintained in the long term. Cessation of medication led to recurrence of symptoms in most cases.

CUA guideline: Diagnosis and treatment of interstitial cystitis/ bladder pain syndrome

“…[95][96][97][98] Patients with Hunner's lesions seem to derive a better response than those without Hunner's lesions (68% vs. 30%, respectively). 96 A single RCT comparing CyA to PPS showed a significant improvement in IC/BPS symptoms with CyA treatment compared to PPS (59% vs. 13%, p<0.001).…”

Interstitial Cystitis

“…Cyclosporine is a calcineurin inhibitor that may act in PBS/IC through inhibition of activation of T cells or mast cell activation. Data are limited, but it gave promising results in small open-label studies (68,69) and in a recent RCT, where patients treated with cyclosporine reported a higher treatment response in comparison with PPS treatment after 6 mo (70). In addition, the response correlated with a decrease in urinary epidermal growth factor concentration, whereas patients in the cyclosporine group had a tendency toward lower urinary IL-6 levels (71).…”

The management of interstitial cystitis: an update

“…37 Furthermore, mean 24-h urinary frequency decreased from 20.8 (standard deviation [SD] 6.3) to 10.2 (SD 3.8), mean maximal bladder capacity increased from 161.8 ml (SD 74.6) to 360.7 ml (SD 99.3), and mean voided volume increased from 101.4 ml (SD 42.7) to 246.4 ml (SD 97.9), all of which were statistically significant compared to baseline. It should be noted that symptoms recurred in all nine patients who stopped CA.…”

“…36,37 In their original report, 11 patients with IC were initially treated with 2.5-5.0 mg/ kg of CA daily, which was then reduced to a 1.5-3.0 mg/ kg/day maintenance dose for 3-6 months. Bladder pain either decreased or disappeared in 10 patients, in addition to significant increases in mean and maximum voided volumes and reduction in voiding frequency.…”