Systemic Therapy for Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC): Systematic Review of Published Trials in the
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BPS/INTERSTITIAL CYSTITIS (D CASTRO-DIAZ AND Y IGAWA, SECTION EDITORS)
Systemic Therapy for Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC): Systematic Review of Published Trials in the Last 5 Years Pedro Abreu-Mendes 1,2 & Rui Pinto 1,2,3 & Paulo Dinis Oliveira 1,2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Systemic drug therapy licensed and present in worldwide guidelines for bladder pain syndrome/interstitial cystitis (BPS/IC) has been relatively stable for the last years. This systematic review aims to assess trials enrolling BPS/IC patients, published in the last 5 years. The authors abided by the preferred reporting items for systematic reviews and metaanalyses (PRISMA) statement to define retrieved trials. The keywords used in the search were “interstitial cystitis”, “bladder pain syndrome” and “trial”. Five additional papers were added: three published before 2015, due to the added value to the present work, and two published in abstract form only, retrieved from previous systematic reviews. Recent Findings The pursuit of better and novel treatment modalities for BPS/IC patients is constant. Different classes of drugs were tried as potential systemic therapy in BPS/IC patients. Among retrieved trials, positive results were reported with sildenafil, certolizumab, amitriptyline, gefapixant, and cyclosporine A. Other drugs failed to prove their efficacy. When using other licensed drugs for BPS/IC, several trials showed inconclusive results or failed to meet the criteria at interim analyses. Summary The interpretation of BPS/IC trial results is not straightforward especially when compared to other pathologies, due to difficulty in characterizing and phenotyping patients. Overall, both positive and inconclusive trials should motivate peers to continue the search for novel therapies in this condition. Trials with better designs and with a larger number of individuals are needed. Keywords Interstitial cystitis . Bladder pain syndrome . Pharmacotherapy . Systemic therapy . Systematic revision . Trials
Introduction By the 2007 ESSIC definition, bladder pain syndrome/ interstitial cystitis (BPS/IC) is “chronic (> 6 months) pelvic pain, pressure or discomfort perceived to be related to the urinary bladder accompanied by at least one other urinary symptom like a persistent urge to void or frequency. Confusable diseases as the cause of the symptoms must be excluded” [1]. This article is part of the Topical Collection on BPS/Interstitial Cystitis * Paulo Dinis Oliveira [email protected] 1
Department of Urology, Hospital São João, Porto, Portugal
2
Department of Surgery and Physiology, Faculty of Medicine of University of Porto, Praça de Gomes Teixeira, 4099-002 Porto, Portugal
3
i3S Institute for Investigation and Innovation in Health, Porto, Portugal
Inherent to its diagnosis, this umbrella-like syndrome includes a large spectrum of possible clinical presentations. The most important task upon phenotyping is to evaluate the presence of Hunner
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