CYCLOSPORINE A AND PENTOSAN POLYSULFATE SODIUM FOR THE TREATMENT OF INTERSTITIAL CYSTITIS: A RANDOMIZED COMPARATIVE STUDY
2005; Lippincott Williams & Wilkins; Volume: 174; Issue: 6 Linguagem: Inglês
10.1097/01.ju.0000181808.45786.84
ISSN1527-3792
AutoresJukka Sairanen, Teuvo L.J. Tammela, Mikael Leppilahti, Markku Multanen, Ilkka Paananen, Kari Lehtoranta, Mirja Ruutu,
Tópico(s)Genital Health and Disease
ResumoNo AccessJournal of UrologyAdult Urology: Infection/Inflammation1 Dec 2005CYCLOSPORINE A AND PENTOSAN POLYSULFATE SODIUM FOR THE TREATMENT OF INTERSTITIAL CYSTITIS: A RANDOMIZED COMPARATIVE STUDY JUKKA SAIRANEN, TEUVO L.J. TAMMELA, MIKAEL LEPPILAHTI, MARKKU MULTANEN, ILKKA PAANANEN, KARI LEHTORANTA, and MIRJA RUUTU JUKKA SAIRANENJUKKA SAIRANEN , TEUVO L.J. TAMMELATEUVO L.J. TAMMELA , MIKAEL LEPPILAHTIMIKAEL LEPPILAHTI , MARKKU MULTANENMARKKU MULTANEN , ILKKA PAANANENILKKA PAANANEN , KARI LEHTORANTAKARI LEHTORANTA , and MIRJA RUUTUMIRJA RUUTU View All Author Informationhttps://doi.org/10.1097/01.ju.0000181808.45786.84AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: In a previous retrospective analysis, cyclosporine A (CyA) was highly efficient in treating patients with interstitial cystitis. A prospective randomized study with this immunosuppressive agent was warranted. We compared CyA to pentosan polysulfate sodium (PPS) in patients with interstitial cystitis. Materials and Methods: A total of 64 patients with interstitial cystitis meeting the National Institute of Diabetes and Digestive and Kidney Diseases criteria were enrolled in a randomized prospective study. Patients were randomized in a 1:1 ratio to 1.5 mg/kg CyA twice daily (27 women, 5 men) or 100 mg PPS 3 times daily (26 women, 6 men) for a period of 6 months. The primary end point was daily micturition frequency, and secondary end points were mean and maximal voided volume, number of nocturia episodes, O'Leary-Sant symptom and problem indexes, visual analogue scale for pain, and subjective global response assessment. Results: CyA was superior to PPS in all clinical outcome parameters measured at 6 months. Micturition frequency in 24 hours was significantly reduced in the CyA arm compared to the PPS arm (-6.7 ± 4.7 vs -2.0 ± 5.1 times). The clinical response rate (according to global response assessment) was 75% for CyA compared to 19% for PPS (p <0.001). Although there were more adverse events in the CyA arm than in the PPS arm, 29 patients completed the 6-month followup in both groups. Conclusions: CyA is more effective than PPS in interstitial cystitis. References 1 : Summary of the National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases Workshop on interstitial cystitis, National Institutes of Health, Bethesda, Maryland, August 28–29, 1987. J Urol1988; 140: 203. Link, Google Scholar 2 : Treatments used in women with interstitial cystitis: the interstitial cystitis data base (ICDB) study experience. The Interstitial Cystitis Data Base Study Group. Urology2000; 56: 940. Crossref, Medline, Google Scholar 3 : A prospective double-blind clinically controlled multicenter trial of sodium pentosanpolysulfate in the treatment of interstitial cystitis and related painful bladder disease. J Urol1987; 138: 503. Link, Google Scholar 4 : Pentosan polysulfate sodium for therapy of interstitial cystitis. A double-blind placebo-controlled clinical study. Urology1990; 35: 552. Google Scholar 5 : A quantitatively controlled method to study prospectively interstitial cystitis and demonstrate the efficacy of pentosanpolysulfate. J Urol1993; 150: 845. Link, Google Scholar 6 : Long-term outcome of patients with interstitial cystitis treated with low dose cyclosporine A. J Urol2004; 171: 2138. Link, Google Scholar 7 : The interstitial cystitis symptom index and problem index. Urology1997; 49: 58. Crossref, Medline, Google Scholar 8 : Cyclosporine in severe interstitial cystitis. J Urol1996; 155: 1591. Link, Google Scholar 9 : Pitfalls in the design of clinical trials for interstitial cystitis. Urology2002; 60: 742. Google Scholar 10 : A pilot clinical trial of oral pentosan polysulfate and oral hydroxyzine in patients with interstitial cystitis. J Urol2003; 170: 810. Link, Google Scholar 11 : Epithelial coating techniques in the treatment of interstitial cystitis. Urology1997; 49: 100. Crossref, Medline, Google Scholar 12 : Mechanisms of action of cyclosporine. Immunopharmacology2000; 47: 119. Google Scholar 13 : The human mast cell: functions in physiology and disease. Front Biosci2001; 6: D1109. Google Scholar 14 : Lymphocyte sub-populations in the bladder wall in normal bladder, bacterial cystitis and interstitial cystitis. Br J Urol1994; 73: 508. Google Scholar 15 : Recruitment, distribution and phenotypes of mast cells in interstitial cystitis. J Urol2000; 163: 1009. Link, Google Scholar From the Department of Urology, Helsinki University Hospital, Helsinki (JS, MR), Department of Surgery/Urology, Tampere University Hospital and Medical School, Tampere (TLJT), Division of Urology, Seinäjoki Central Hospital, Seinäjoki (ML), Department of Surgery, Kuusankoski District Hospital, Kuusankoski (MM), Department of Urology, Oulu University Hospital, Oulu (IP), and Department of Surgery, Päijät-Häme Central Hospital, Lahti (KL), Finland© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byClemens J, Erickson D, Varela N and Lai H (2022) Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain SyndromeJournal of Urology, VOL. 208, NO. 1, (34-42), Online publication date: 1-Jul-2022.Forrest J, Payne C and Erickson D (2012) Cyclosporine A for Refractory Interstitial Cystitis/Bladder Pain Syndrome: Experience of 3 Tertiary CentersJournal of Urology, VOL. 188, NO. 4, (1186-1191), Online publication date: 1-Oct-2012.Yang C, Burks D, Propert K, Mayer R, Peters K, Nickel J, Payne C, FitzGerald M, Hanno P, Chai T, Kreder K, Lukacz E, Foster H, Cen L, Landis J, Kusek J and Nyberg L (2011) Early Termination of a Trial of Mycophenolate Mofetil for Treatment of Interstitial Cystitis/Painful Bladder Syndrome: Lessons LearnedJournal of Urology, VOL. 185, NO. 3, (901-906), Online publication date: 1-Mar-2011.Chuang Y, Lee W, Lee W and Chiang P (2009) Intravesical Liposome Versus Oral Pentosan Polysulfate for Interstitial Cystitis/Painful Bladder SyndromeJournal of Urology, VOL. 182, NO. 4, (1393-1400), Online publication date: 1-Oct-2009. Volume 174Issue 6December 2005Page: 2235-2238 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsinterstitialcyclosporinepentosan sulfuric polyesterdrug therapycystitisMetrics Author Information JUKKA SAIRANEN More articles by this author TEUVO L.J. TAMMELA More articles by this author MIKAEL LEPPILAHTI More articles by this author MARKKU MULTANEN More articles by this author ILKKA PAANANEN More articles by this author KARI LEHTORANTA More articles by this author MIRJA RUUTU More articles by this author Expand All Advertisement PDF downloadLoading ...
Referência(s)