Current evidence also suggests the efficacy of  dimethyl sulfoxide and amitryptyline therapy .
Hydroxyzine , intravesical bacille Calmette-Guérin  , and  resiniferatoxin therapy  failed to demonstrate efficacy , but evidence was inconclusive owing to method ological limitations .
Pentosan polysulfate may be modestly beneficial for symptoms of PBS/IC .
There is insufficient evidence for other pharmacologic treatments .
BACKGROUND More than 180 different types of therapy have been used in the treatment and management of  painful bladder syndrome/interstitial cystitis ( PBS/IC ) , yet evidence from clinical trials remains inconclusive .
This study aim ed to evaluate the efficacy of pharmacologic approaches to PBS/IC , to quantify the effect size from r and omized controlled trials , and to begin to inform a clinical consensus of treatment efficacy for PBS/IC .
Randomized, double-blind, dose-ranging study of pentosan polysulfate sodium for interstitial cystitis.
OBJECTIVES To compare the current recommended dose of pentosan polysulfate sodium ( PPS ) with doses two to three times higher . METHODS We evaluated three dosages ( 300 , 600 , and 900 mg ) of PPS in a r and omized , double-blind , double-dummy , parallel-group , multicenter , 32-week study . Adults ( n = 380 ) with a diagnosis of interstitial cystitis ( IC ) as determined by a positive cystoscopic examination combined with bladder pain and urgency or a history of IC symptoms for at least 6 months were enrolled . Participants completed the Patient 's Overall Rating of Symptom Index ( PORIS ) and the O'Leary-Sant Interstitial Cystitis Symptom Index ( ICSI ) at baseline ( ICSI only ) and during follow-up visits at 4 , 8 , 12 , 16 , 24 , and 32 weeks . RESULTS Mean ICSI scores improved significantly during the 32 weeks for all dosages ( baseline 11.2 , 11.9 , and 11.9 to endpoint 8.2 , 8.1 , 8.6 for 300 , 600 , and 900 mg , respectively ; P < 0.001 ) but the response to treatment was not dose dependent ( no statistically significant difference in response among the three dosages ) . At baseline , 3.2 % , 62.2 % , and 34.6 % reported mild , moderate , and severe symptoms , respectively , as assessed by the ICSI . At study end , 27.5 % , 56.9 % , and 15.7 % reported mild , moderate , and severe symptoms , respectively . The PORIS scores improved within 4 weeks with 15.8 % to 21.1 % of all patients classified as responders ( 50 % or greater improvement on PORIS ) . At 32 weeks , 49.6 % , 49.6 % , and 45.2 % of all patients were responders at a dose of 300 , 600 , and 900 mg , respectively . Most adverse events were mild and resolved without intervention . CONCLUSIONS For all three dosages of PPS , a clinical ly significant but similar response was demonstrated . The duration of therapy appears to be more important than the dosage
Current evidence also suggests the efficacy of  dimethyl sulfoxide and amitryptyline therapy .
Hydroxyzine , intravesical bacille Calmette-Guérin  , and  resiniferatoxin therapy  failed to demonstrate efficacy , but evidence was inconclusive owing to method ological limitations .
Pentosan polysulfate may be modestly beneficial for symptoms of PBS/IC .
There is insufficient evidence for other pharmacologic treatments .
BACKGROUND More than 180 different types of therapy have been used in the treatment and management of  painful bladder syndrome/interstitial cystitis ( PBS/IC ) , yet evidence from clinical trials remains inconclusive .
This study aim ed to evaluate the efficacy of pharmacologic approaches to PBS/IC , to quantify the effect size from r and omized controlled trials , and to begin to inform a clinical consensus of treatment efficacy for PBS/IC .