Treatments used in women with interstitial cystitis: the Interstitial Cystitis Data Base (ICDB) study experience

Rovner, E.S.; Propert, Kathleen J.; Brensinger, Colleen M.; Wein, Alan J.; Foy, Marilou; Kirkemo, Aaron; Landis, J. Richard; Kusek, John W.; Nyberg, Leroy M.

doi:10.1016/s0090-4295(00)00845-1

Cited by 131 publications

(64 citation statements)

References 17 publications

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“…16 The FDA approved PPS for the treatment of BPS in 1996. There is, however, a limited long-term report on its efficacy and tolerability.…”

Section: Discussionmentioning

confidence: 99%

Long-term efficacy and tolerability of pentosan polysulphate sodium in the treatment of bladder pain syndrome

Al-Zahrani¹,

Gajewski²

2013

CUAJ

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Objective: The primary objective of this study is to report on thelong-term efficacy and tolerability of pentosan polysulphate sodium(PPS) in patients with bladder pain syndrome (BPS). The secondaryobjective is to find the predictors of the long-term outcome.Methods: This is a single institution, retrospective study. The studyperiod was from 1994 to 2008. All patients fulfilled the clinicalcriteria of BPS, as suggested by European Society for the Study ofInterstitial Cystitis. We included only patients with de novo BPSdiagnosis and no previous PPS or other treatment. The efficacyof PPS was measured with the global response assessment scale(GRA). Patients were stratified into 2 groups based on the durationof the treatment. Group 1 took the drug for less than 12 months.Group 2 took the drug for more than 12 months.Results: There were 271 patients eligible for the study. Most of thepatients were female (90%), with the mean age at presentation of45.5 years. The average duration of symptoms was 28.5 months.The mean follow-up was 22 months (range 3-130). Out of all thepatients, 147 patients (54.2%) reported over 50% improvementusing the GRA. The reported efficacy was higher in Group 2 (60%).Ninety-three patients (34.3%) decided to stop taking the medicationfor various reasons. The most common reasons to stop themedication were poor outcome (16.6% of patients) and side effects(11.1% of patients). Poor outcome was associated with nocturia,smoking and detrusor overactivity. Good outcome was associatedwith longer PPS intake (>12 months) and severe cystoscopic findingsof glomerulation.Conclusion: Pentosan polysulphate sodium is an effective oraltherapy to control the symptoms of BPS with good long-term efficacyand tolerability.

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“…16 The FDA approved PPS for the treatment of BPS in 1996. There is, however, a limited long-term report on its efficacy and tolerability.…”

Section: Discussionmentioning

confidence: 99%

Long-term efficacy and tolerability of pentosan polysulphate sodium in the treatment of bladder pain syndrome

Al-Zahrani¹,

Gajewski²

2013

CUAJ

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“…163 Observational studies have shown efficacy rates ranging from 30-54% at one month; 18-56% at two to three months; and 0-37% at five to six months. 19,164,165 There is a lack of standardized protocol throughout studies.…”

Section: Hydrodistension (Hd) (Option Grade C)mentioning

confidence: 99%

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

Cox

Golda

Nadeau

et al. 2016

CUAJ

113

121

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MethodologyThe following guidelines were based on MEDLINE and PUBMED searches of English language literature, in addition to consensus conference proceedings. Levels of evidence and grades of recommendation were assigned for each investigation and treatment, as per the modified Oxford Centre for Evidence-Based Medicine grading system. Where the literature was inconsistent or scarce, a consensus expert opinion was generated to provide treatment guidelines.

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“…54 α Antagonists and antimuscarinics are widely used for CP/CPPS 55 and antimuscarinics are used for IC. 56 α-Blockers may also be useful for IC based on the data suggesting activity in the bladder and spinal cord. A limitation to treating IC and CP/CPPS is a lack of understanding of the pathophysiology of the conditions.…”

Section: Patients With Neurogenic Bladdermentioning

confidence: 99%

COMBINED USE OF Α-Adrenergic AND MUSCARINIC ANTAGONISTS FOR THE TREATMENT OF VOIDING DYSFUNCTION

2005

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Purpose-We provide an overview of the medical literature supporting the combined use of muscarinic and α-adrenergic antagonist therapy for the treatment of voiding dysfunction. The MEDLINE database (1966 of the United States National Library of Medicine was searched for pertinent studies. Materials and Methods-Results-Although the mechanism of action of α-adrenergic antagonist therapy for voiding dysfunction has traditionally been assumed to be relaxation of the periurethral, prostatic and bladder neck smooth muscle, substantial evidence supports action at extraprostatic sites involved in micturition, including the bladder dome smooth muscle, peripheral ganglia, spinal cord and brain. Likewise the mechanism of action of anticholinergic therapy has been traditionally assumed to be inhibition of the M 3 muscarinic receptor subtypes that mediate normal bladder contractions. However, M 2 receptor mediates hypertrophied bladder contractions and there is evidence for an M 2 component to the suprasacral control of voiding.Conclusions-Based on the physiology of α-adrenergic and muscarinic receptors the inhibition of each one would be expected to be more beneficial than that of either alone because they would work on 2 components of detrusor function. Patients who would likely benefit from this combination therapy are men with lower urinary tract symptoms, women with urgency/frequency syndrome (overactive bladder), patients with uninhibited bladder contractions due to neurogenic bladder, and patients with pelvic pain and voiding symptoms, ie interstitial cystitis and chronic prostatitis/chronic pelvic pain syndrome. Keywordsbladder; prostate; adrenergic alpha-antagonists; muscarinic antagonists; urination disorders The wide range of patients who might benefit from this type of treatment combination is considered to be large, perhaps several times the estimated 17 million patients in the United States with overactive bladder. 1 A patent application has been filed for the treatment of lower urinary tract (LUT) symptoms (LUTS) in men with benign prostatic hyperplasia (BPH) with this combination. 2

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Treatments used in women with interstitial cystitis: the Interstitial Cystitis Data Base (ICDB) study experience

Cited by 131 publications

References 17 publications

Long-term efficacy and tolerability of pentosan polysulphate sodium in the treatment of bladder pain syndrome

Long-term efficacy and tolerability of pentosan polysulphate sodium in the treatment of bladder pain syndrome

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

COMBINED USE OF Α-Adrenergic AND MUSCARINIC ANTAGONISTS FOR THE TREATMENT OF VOIDING DYSFUNCTION

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