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Pharmacological treatments of interstitial cystitis: a review of the literature

Zilinskas, Anna Leigh (2017) Pharmacological treatments of interstitial cystitis: a review of the literature. Master Essay, University of Pittsburgh.

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PDF (Table 1. Comprehensive Summary Table on Literature Review of Pentosan Polysulfate)
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PDF (Table 2. Comprehensive Summary Table on Literature Review of Dimethyl Sulfoxide)
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PDF (Table 3. Comprehensive Summary Table on Literature Review of Onabotulinum Toxin A)
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Abstract

It is reported that three to eight million women suffer from interstitial cystitis/bladder pain syndrome in the United States. Two front-line pharmacological methods of treatment include: Pentosan Polysulfate and Dimethyl Sulfoxide. Secondary to these treatments, patients can receive injections of Onabotulinum Toxin A, although not FDA approved. The primary objective of this literature review was to examine the existing work and identify the gaps in knowledge surrounding the current treatment protocols. A literature review was conducted through the PubMed database on November 1, 2017 yielding 21 articles that met inclusion criteria. Each article was reviewed for adherence to topic, method, results, and limitations. Overall, the nature of all the papers evaluated was generally lacking relevant details to directly compare across studies. This included missing relevant information on age and racial breakdown of patients, making it difficult to decipher if there is an age or race effect on treatment improvement by modality, and lack of information on the magnitude of the change in the key symptomatology outcome measures. However, these studies still provided valuable information to preliminarily compare their effectiveness and is a first step towards designing better trials to evaluate this problem. In conclusion, there is limited research on DMSO, with most recent findings unsupportive of the treatment. Orally administered PPS has the best-designed studies, with multiple placebo controlled, randomized clinical trials supporting the efficacy of symptom treatment, but findings indicated limited success in symptom reduction. While Onabotulinum Toxin A is considered to be a treatment that is administered at a later point of disease treatment, there is a substantial amount of published research that uses updated methods of pain and symptom evaluation which leads to a belief of efficacy. Given the stronger findings for Onabotulinum Toxin A, future research should be directed to determine if this modality should be considered as the primary intravesical treatment method of IC/BPS treatment despite its possible side effect of increasing UTIs. The public health implications of the existing and future work could allow for quicker and more effective relief of symptoms of IC/BPS for the millions of adults suffering from this painful condition.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Zilinskas, Anna Leighalz32@pitt.edualz32
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairGlynn, Nancyglynnn@edc.pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberTerry, Marthamaterry@pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberTyagi, Pradeeptyagip@upmc.eduUNSPECIFIEDUNSPECIFIED
Date: December 2017
Date Type: Submission
Number of Pages: 38
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 17 Jul 2018 22:49
Last Modified: 17 Jul 2018 22:49
URI: http://d-scholarship.pitt.edu/id/eprint/33677

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