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 .
Long-term results of amitriptyline treatment for interstitial cystitis.
PURPOSE We have conducted a prospect i ve open-label study to examine the safety and efficacy of the long-term administration of the tricyclic antidepressant amitriptyline in patients with interstitial cystitis ( IC ) . METHODS Patients were stratified into 2 groups : an NIDDK group including patients fulfilling the NIDDK criteria for IC and a non-NIDDK group encompassing patients who presented the characteristic IC symptoms but met at least one of the NIDDK exclusion criteria .  Amitriptyline was taken strictly at bedtime following an established self-titration protocol without a limitation of the maximum daily dosage . Patients reporting improvement in a global response assessment question naire were defined as treatment responders . Further efficacy measures included changes of pain and urgency , functional bladder capacity and frequency . Changes in the O'Leary-Sant IC index and rating of overall satisfaction with the therapeutic outcome are reported as well . RESULTS The mean follow-up of the study was 19.0 + /- 12.5 months . The response rate was 64 % ( 60 patients ) . Overall mean dosage was 55 mg ( range : 12.5 - 150 mg ) . Side effects occurred in 79 patients ( 84 % ) ( dry mouth : 79 % , weight gain : 59 % ) . Patient overall satisfaction with the therapeutic result was either excellent or good in 43 patients ( 46 % ) . The drop-out rate was 31 % ( 29 patients ) after a mean treatment period of 6 weeks at a mean dosage of 70 mg . Non-response to treatment was the primary reason for drop-out in all cases , side effects contributed to drop-out in 25 patients ( 86 % ) . The various IC symptoms improved statistically significant compared with baseline . CONCLUSIONS Long-term administration of amitriptyline is a feasible , safe and effective treatment for IC provided that the drug is used judiciously to minimise adverse effects . The therapeutic response to amitriptyline was uniformly observed in patients fulfilling the NIDDK criteria and in those patients with the pure clinical diagnosis of IC
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 .