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literature on oral treatment of BPS  

ESSIC uses the name bladder pain syndrome (BPS) instead of interstitial cystitis (IC) and/or painful bladder syndrome (PBS):
click here
for more details.


this section is divided into: double-blind randomized placebo-controlled studies  
  open studies and non-placebo-controlled studies  
  case reports  
double-blind randomized placebo-controlled studies  
  • Randomized, double-blind, dose-ranging study of pentosan polysulfate sodium for interstitial cystitis.
    Nickel JC, Barkin J, Forrest J, et al. Urology 2005;65:654-8
    three dosages (300, 600, and 900 mg) of PPS in a randomized, double-blind, double-dummy, parallel-group, multicenter, 32-week study were studied in 380 IC patients
    at study end, 27.5%, 56.9%, and 15.7% reported mild, moderate, and severe symptoms, respectively
    • for all three dosages of PPS, a clinically significant but similar response was demonstrated; the duration of therapy appears to be more important than the dosage
  • Pilot study of sequential oral antibiotics for the treatment of interstitial cystitis.
    Warren JW, Horne LM, Hebel JR, et al. J Urol 2000;163:1685-8
    • 50 patients with IC were randomized to receive 18 weeks of placebo or antibiotics, including rifampin plus a sequence of doxycycline, erythromycin, metronidazole, clindamycin, amoxicillin and ciprofloxacin for 3 weeks each.
    • 12 of 25 patients (48%) in the antibiotic and 6 of 25 (24%) in the placebo group reported overall improvement (p = 0.14), while 10 and 5, respectively, noticed improvement in pain and urgency (p = 0.22).
    • in the antibiotic group 20 participants (80%) had adverse effects compared with 10 (40%) in the placebo group (p = 0.009).
    • the authors conclude that their findings suggest that these antibiotics alone or in combination may sometimes be associated with decreased symptoms in some patients but they do not represent a major advance in therapy for interstitial cystitis
  • A prospective double-blind clinically controlled multicenter trial of sodium pentosanpolysulfate in the treatment of interstitial cystitis and related painful bladder disease.
    Holm-Bentzen M, Jacobsen F, Nerstrom B, et al. J Urol 1987;138:503-7
    • protocol A included 43 patients with clinically and pathologically anatomically verified interstitial cystitis (28 or more mast cells per mm.2)
    • protocol B included 72 patients with a painful bladder and unspecific histological findings
    • patients were randomized to receive either sodium pentosanpolysulfate (200 mg. twice daily) or placebo capsules for 4 months
    • before and after the trial the patients were evaluated with symptom grading, urodynamics and cystoscopy with distension and deep bladder biopsies
    • the results showed no difference between the pre-trial and post-trial values in the sodium pentosanpolysulfate and placebo groups in both protocols in regard to symptoms, urodynamic parameters, cystoscopic appearance and mast cell counts.
    • a significant increase in the cystoscopically determined bladder capacity in the sodium pentosanpolysulfate group in protocol A was found
    • the authors conclude that no statistically or clinically significant effect of sodium pentosanpolysulfate was found compared to placebo in patients with painful bladder disease
open studies and non-placebo-controlled studies  
case reports  
  • Efficacy of interstitial cystitis treatments: a review.
    Karsenty G, AlTaweel W, Hajebrahimi S, Corcos J. EAU-EBU Update Series 2006;4:47-61
    • in this article, the degree of evidence regarding the clinical efficacy of available interstitial cystitis treatment options is reviewed
    • only three therapies are supported by a high level of evidence: oral cimetidine and amitriptyline and the intravesical dimethylsulfoxide (DMSO)
  • Chondroitin sulfate for interstitial cystitis.
    Palylyk-Colwell E. Issues Emerg Health Technol 2006 May;(84):1-4
    • this review concludes that two non-randomized, uncontrolled pilot studies reported improvements in patient-reported symptoms after the use of chondroitin sulfate for one year
    • the author also concludes that prospective, randomized, head-to-head trials are needed to assess the effectiveness of this technology compared with other IC therapies
  • Antidepressants and cognitive-behavioral therapy for symptom syndromes.
    Jackson JL, O'malley PG, Kroenke K. CNS Spectr 2006;11:212-22
    • this article reviews the randomized controlled trial data for the use of antidepressant and cognitive-behavior therapy for 11 somatic syndromes: irritable bowel syndrome, chronic back pain, headache, fibromyalgia, chronic fatigue syndrome, tinnitus, menopausal symptoms, chronic facial pain, noncardiac chest pain, interstitial cystitis, and chronic pelvic pain
  • Patient perceived outcomes of treatments used for interstitial cystitis.
    Hill JR, Isom-Batz G, Panagopoulos G, et al. Urology 2008;71:62-6
    • 750 patients with a diagnosis of IC completed a computerized survey that queried each patient about their demographics, symptoms, concomitant diagnoses, treatments, and their perceived treatment outcomes
    • the authors conclude that medical therapy is perceived to be superior to invasive therapy in the treatment and that several medications showed a large percentage of patients with improvement in symptoms
    • these medications were calcium glycerophosphate, phenazopyridine and pentosan polysulfate sodium

    comment: this study may be biased as the survey was a direct link from 3 websites, at least one of them being a commercial site
  © 2004-2018 ESSIC - International Society for the Study of Bladder Pain Syndrome  
14.12.2008 15:39