Meta- analysis of RCTs showed that only cyclosporine A provided a simultaneous great effect size of SMD on ICSI , pain , and frequency .
Amitriptyline at different dosages showed a great effect size of SMD on pain and urgency or on ICSI and frequency .
The results from the n RCTs showed that the most frequently adopted treatment is oral pentosan polysulfate and that the use of botulinum A toxin intradetrusorial injections in PBS/IC is increasing .
Limited evidence exists for the few treatments for PBS/IC .
The lack of definitive conclusions is due to the great heterogeneity in methodology , symptoms assessment , duration of treatment , and follow-up in both RCTs and n RCTs
CONTEXT Different types of behavioural , dietary , interventional , pharmacologic , and surgical therapies have been used to treat painful bladder syndrome/interstitial cystitis ( PBS/IC ) .
Because of the paucity of r and omised placebo-controlled studies on different treatments , an evidence -based management approach has not yet been developed .
OBJECTIVE To critically review and synthesize data from a wide range of current therapeutic approaches to PBS/IC , to quantify the effect size from r and omised controlled trials ( RCTs ) , and to reach clinical agreement on the efficacy of treatments for PBS/IC .
The dual serotonin and noradrenaline reuptake inhibitor duloxetine for the treatment of interstitial cystitis: results of an observational study.
PURPOSE We report an observational study to evaluate the efficacy and tolerability of duloxetine for interstitial cystitis . MATERIAL S AND METHODS A total of 48 women were prospect ively treated for 2 months following an uptitration protocol to the target dose of 2 x 40 mg duloxetine per day . Patients received the target dose for 5 weeks . The efficacy of duloxetine treatment was assessed at week 8 . The primary end point was a change in the overall well-being evaluated by a patient reported global response assessment . Secondary end points were changes in pain and urgency ( visual analog scales ) , frequency and functional bladder capacity ( 48-hour voiding log ) , and changes in overall symptom severity ( O'Leary-Sant index ) . RESULTS There were 5 patients ( 10.4 % ) who were identified as responders and 17 patients ( 35.4 % ) who dropped out of the study exclusively due to side effects , with nausea present in all dropouts . No severe adverse events were reported . All 5 responders reported onset of symptom improvement but not until they had reached the target dose . Regarding secondary outcome parameters , duloxetine treatment did not result in statistically significant improvement of symptoms . Maximum urinary flow rate and residual volume were influenced more prominently in patients at the target dose , however , the changes did not appear to be clinical ly meaningful . CONCLUSIONS Treatment of interstitial cystitis with duloxetine did not result in significant improvement of symptoms . The drug administration was safe but the tolerability of the drug was poor mainly due to nausea occurring with the starting dose of 20 mg per day . Based on the preliminary data of this observational trial we currently can not recommend duloxetine as a therapeutic approach for interstitial cystitis
Meta- analysis of RCTs showed that only cyclosporine A provided a simultaneous great effect size of SMD on ICSI , pain , and frequency .
Amitriptyline at different dosages showed a great effect size of SMD on pain and urgency or on ICSI and frequency .
The results from the n RCTs showed that the most frequently adopted treatment is oral pentosan polysulfate and that the use of botulinum A toxin intradetrusorial injections in PBS/IC is increasing .
Limited evidence exists for the few treatments for PBS/IC .
The lack of definitive conclusions is due to the great heterogeneity in methodology , symptoms assessment , duration of treatment , and follow-up in both RCTs and n RCTs
CONTEXT Different types of behavioural , dietary , interventional , pharmacologic , and surgical therapies have been used to treat painful bladder syndrome/interstitial cystitis ( PBS/IC ) .
Because of the paucity of r and omised placebo-controlled studies on different treatments , an evidence -based management approach has not yet been developed .
OBJECTIVE To critically review and synthesize data from a wide range of current therapeutic approaches to PBS/IC , to quantify the effect size from r and omised controlled trials ( RCTs ) , and to reach clinical agreement on the efficacy of treatments for PBS/IC .