Comparative effectiveness and safety of intravesical instillation treatment of interstitial cystitis/bladder pain syndro
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REVIEW ARTICLE
Comparative effectiveness and safety of intravesical instillation treatment of interstitial cystitis/bladder pain syndrome: a systematic review and network meta-analysis of randomized controlled trials Shengzhuo Liu 1 & Chi Zhang 1 & Liao Peng 1 & Yiping Lu 1 & Deyi Luo 1 Received: 22 June 2020 / Accepted: 2 August 2020 # The International Urogynecological Association 2020
Abstract Introduction and hypothesis A large variety of agents are available for intravesical instillation treatment of interstitial cystitis/ bladder pain syndrome (IC/BPS). The purpose of the study was to compare the efficacy and safety of those agents. Methods PubMed, the Cochrane Library, and Embase were searched from database inception to February 2020 for randomized controlled trials. The language of publication was limited in English. Population, intervention, comparison, outcome, and study design was used to assess the eligible studies for inclusion and the Cochrane Collaboration’s risk of bias tool was used to assess the methodological quality of the studies included. The primary outcome was O’Leary–Sant Interstitial Cystitis Problem Index (ICPI) and O’Leary–Sant Interstitial Cystitis Symptom Index (ICSI) improvement. Results Eleven randomized controlled trials covering 8 agents with 902 patients were enrolled. According to the results of the ICPI and ICSI, 0.1 μM resiniferatoxin was more effective than other therapies. Combination therapy of hyaluronic acid and chondroitin sulphate ranked second in ICSI, third in ICPI, and first in the visual analog scale (VAS). Among regimens included for complication comparison, chondroitin sulphate was safer than other agents, with a probability of 78.5%. Conclusions Resiniferatoxin (0.1 μM) is more effective at ICPI and ICSI improvement than other agents. More well-designed randomized controlled trials with a large sample size directly comparing the efficacy and safety of those agents are in need in the future to confirm our findings. Keywords Interstitial cystitis . Bladder pain syndrome . Intravesical instillation . Bladder drug administration . Meta-analysis
Abbreviations BCG Bacillus Calmette–Guerin BPS Bladder pain syndrome CHS Chondroitin sulphate CI Confidence interval DMSO Dimethyl sulphoxide
Shengzhuo Liu and Chi Zhang contributed equally to this work Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00192-020-04490-3) contains supplementary material, which is available to authorized users * Deyi Luo [email protected] 1
Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, People’s Republic of China
HAAC HAAS IC ICPI ICSI Lipotoxin MD ONBA PICOS PSD597 RCT RT RTX VAS
Hyaluronic acid Combination of hyaluronic acid and chondroitin sulphate Interstitial cystitis O’Leary–Sant Interstitial Cystitis Problem Index O’Leary–Sant Interstitial Cystitis Symptom Index ONBA plus liposomes Mean difference OnabotulinumtoxinA Population, intervention, comparison
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