Efficacy, Side Effects, and Monitoring of Oral Cyclosporine in Interstitial Cystitis-Bladder Pain Syndrome

Urology
Iryna M CrescenzeDaniel A Shoskes

Abstract

To evaluate the efficacy of oral cyclosporine A (CyA) in the treatment of refractory interstitial cystitis-bladder pain syndrome (IC-BPS) and to assess safety using drug level and renal function monitoring. Patients with IC-BPS who failed at least 2 prior treatments were enrolled in an open-label study of oral CyA. Medication was started at 3 mg/kg divided twice daily for 3 months. Dose was adjusted based on side effects and the drug level was measured 2 hours after the morning dose (C2). The primary end point was moderate or marked improvement of global response assessment or >50% improvement on the Interstitial Cystitis Symptom Index (ICSI) or Interstitial Cystitis Problem Index at 3 months. Twenty-two of 26 patients completed the 3-month follow-up; 18 completed the poststudy evaluation. The median symptom duration was 66 months (12-336). At 3 months, 31% (8/26) improved by global response assessment, 15% (4/26) had >50% improvement in the ICSI score, and 19% (5/26) had an improvement in the Interstitial Cystitis Problem Index score. Hunner lesions (HLs) predicted an improvement in the ICSI score (odds ratio = 15.4, 95% confidence interval: 1.7-224.6, P = .01), with 75% (3/4) of the responders having HL. Two patients withdrew...Continue Reading

Citations

Sep 7, 2017·Expert Opinion on Biological Therapy·Ioannis MykoniatisVladimir Yutkin
Jul 5, 2018·Expert Opinion on Pharmacotherapy·Laura L GiustoDaniel A Shoskes
Jul 24, 2018·Therapeutic Advances in Urology·Esther HanKenneth Peters
Apr 16, 2020·International Journal of Urology : Official Journal of the Japanese Urological Association·Yukio HommaKyu-Sung Lee
May 31, 2019·International Journal of Urology : Official Journal of the Japanese Urological Association·Yukio Homma
Aug 22, 2021·Obstetrics and Gynecology Clinics of North America·Catherine Chandler Moody, Tola B Fashokun
Oct 6, 2021·Female Pelvic Medicine & Reconstructive Surgery·Annah VollstedtKenneth Peters

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