Long-term results of intravesical hyaluronan therapy in bladder pain syndrome/interstitial cystitis

Engelhardt, Paul F.; Morakis, Nike; Daha, Lukas K.; Esterbauer, Britta; Riedl, Claus R.

doi:10.1007/s00192-010-1294-y

Cited by 89 publications

(72 citation statements)

References 17 publications

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“…The largest ES in all CT studies was observed for HMW-HA in the study by Shao et al (Fig. 2) [34], with similar findings in two UCT studies with HMW-HA [16,40] by a superior Bd^for average VAS difference. Closest to this VAS reduction were the results obtained using 300 mg of intravesical PPS [47].…”

Section: Evaluation Of Efficacysupporting

confidence: 71%

“…The final set of 19 articles on intravesical BPS/IC therapy was further qualitatively and quantitatively analysed: 5 studies were prospective controlled trials [34][35][36][37][38], 1 compared different intravesical products [39], 1 paper was designed as a retrospective study [40], and another 1 compared two different regimens of the same product [41]. The rest of the trials were classified as uncontrolled clinical studies (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…By far the largest effect sizes (d>2) for symptom reduction were found in 3 studies performed with HMW-HA [16,34,40].…”

Section: Discussionmentioning

confidence: 96%

“…Diagnosis of BPS/IC has been made according to NIDDK/ National Institutes of Health criteria in most studies (one including cystoscopic examination [42]), except for three publications (ESSIC criteria [40], the East Asian guidelines [41] or clinical perception plus cystoscopy [38]). …”

Section: Patients Characteristicsmentioning

confidence: 99%

See 3 more Smart Citations

A Systematic Review and Meta-analysis on the Efficacy of Intravesical Therapy for Bladder Pain Syndrome/Interstitial Cystitis

Barua

Arance

Angulo

et al. 2016

Obstetrical &Amp; Gynecological Survey

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Bladder pain syndrome/interstitial cystitis (BPS/ IC) is a chronic disease characterised by persistent irritating micturition symptoms and pain. The objective was to compare the clinical efficacy of currently available products for intravesical therapy of BPS/IC and to assess their pharmacoeconomic impact. A Pubmed/Medline database search was performed for articles on intravesical therapy for BPS/IC. A total of 345 publications were identified, from which 326 were excluded. Statistical evaluation was performed with effect size (ES) assessment of symptom reduction and response rates. The final set of 19 articles on intravesical BPS/IC therapy included 5 prospective controlled trials (CTs), the remaining were classified as uncontrolled clinical studies. The total number of patients included was 801, 228 of whom had been evaluated in a CT. For CTs, the largest ES for symptom reduction as well as response rate was observed for high molecular weight hyaluronic acid (HMW-HA), with similar findings in two uncontrolled studies with HMW-HA. The number needed to treat to achieve a response to intravesical therapy was 2.67 for intravesical pentosan polysulphate and 1.31 for HMW-HA which were superior to all other instillates.HMW-HA was significantly superior in cost effectiveness and cost efficacy to all other instillation regimes. The present meta-analysis combined medical and pharmacoeconomic aspects and demonstrated an advantage of HMW-HA over other instillation agents; however, direct comparisons between the different products have not been performed to date in properly designed controlled studies.

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Section: Evaluation Of Efficacysupporting

confidence: 71%

Section: Resultsmentioning

confidence: 99%

“…By far the largest effect sizes (d>2) for symptom reduction were found in 3 studies performed with HMW-HA [16,34,40].…”

Section: Discussionmentioning

confidence: 96%

Section: Patients Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

A Systematic Review and Meta-analysis on the Efficacy of Intravesical Therapy for Bladder Pain Syndrome/Interstitial Cystitis

Barua

Arance

Angulo

et al. 2016

Obstetrical &Amp; Gynecological Survey

Self Cite

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“…9 Chondroitin sulfate (Uracyst, Gepan) -A meta-analysis by Thakkinstian et al has shown a global response rate of 43% in the chondroitin sulfate group when compared to placebo. 10 Pentosan polysulfate (PPS) -Most effective when combined with oral PPS; however, not readily available in the UK.…”

Section: Bladder Instillationsmentioning

confidence: 99%

The challenge of bladder pain syndrome

Alnajjar¹,

Biers²

2017

Trends Urology & Men Health

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A high molecular weight hyaluronic acid biphasic dispersion as potential therapeutics for interstitial cystitis

et al. 2020

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Interstitial cystitis (IC) is a progressive bladder disease characterized by increased urothelial permeability, inflammation of the bladder with abdominal pain. While there is no consensus on the etiology of the disease, it was believed that restoring the barrier between urinary solutes and (GAG) urothelium would interrupt the progression of this disease. Currently, several treatment options include intravesical delivery of hyaluronic acid (HA) and/or chondroitin sulfate solutions, through a catheter to restore the urothelial barrier, but have shown limited success in preclinical, clinical trials. Herein we report for the first time successful engineering and characterization of biphasic system developed by combining cross‐linked hyaluronic acid and naïve HA solution to decrease inflammation and permeability in an in vitro model of interstitial cystitis. The cross‐linking of HA was performed by 4‐arm‐polyethyeleneamine chemistry. The HA formulations were tested for their viscoelastic properties and the effects on cell metabolism, inflammatory markers, and permeability. Our study demonstrates the therapeutic effects of different ratios of the biphasic system and reports their ability to increase the barrier effect by decreasing the permeability and alteration of cell metabolism with respect to relative controls. Restoring the barrier by using biphasic system of HA therapy may be a promising approach to IC.

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Long-term results of intravesical hyaluronan therapy in bladder pain syndrome/interstitial cystitis

Abstract: Besides a high rate of acute symptom remission, intravesical hyaluronan also shows long-term efficacy in a considerable number of BPS/IC patients.

Cited by 89 publications

References 17 publications

A Systematic Review and Meta-analysis on the Efficacy of Intravesical Therapy for Bladder Pain Syndrome/Interstitial Cystitis

A Systematic Review and Meta-analysis on the Efficacy of Intravesical Therapy for Bladder Pain Syndrome/Interstitial Cystitis

The challenge of bladder pain syndrome

A high molecular weight hyaluronic acid biphasic dispersion as potential therapeutics for interstitial cystitis

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