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Cyclosporine A and pentosan polysulfate sodium for the treatment of interstitial cystitis: a randomized comparative study.

AbstractPURPOSE:
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.
AuthorsJukka Sairanen, Teuvo L J Tammela, Mikael Leppilahti, Markku Multanen, Ilkka Paananen, Kari Lehtoranta, Mirja Ruutu
JournalThe Journal of urology (J Urol) Vol. 174 Issue 6 Pg. 2235-8 (Dec 2005) ISSN: 0022-5347 [Print] United States
PMID16280777 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Immunosuppressive Agents
  • Pentosan Sulfuric Polyester
  • Cyclosporine
Topics
  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal (adverse effects, therapeutic use)
  • Cyclosporine (adverse effects, therapeutic use)
  • Cystitis, Interstitial (complications, drug therapy, epidemiology)
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents (adverse effects, therapeutic use)
  • Male
  • Middle Aged
  • Pentosan Sulfuric Polyester (adverse effects, therapeutic use)
  • Prospective Studies
  • Syncope (etiology, prevention & control)
  • Treatment Outcome

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