An evaluation of the pharmacotherapy for interstitial cystitis

Expert Opin Pharmacother. 2018 Jul;19(10):1097-1108. doi: 10.1080/14656566.2018.1491968. Epub 2018 Jul 4.

Abstract

Introduction: Interstitial cystitis (IC) and bladder pain syndrome (BPS) are chronic conditions that can be debilitating for patients. There is no consensus as to their etiology, and there are many proposed treatment algorithms. Oftentimes multimodal therapy, such as combining behavioral modification and physical therapy alongside pharmacotherapies, will be utilized. With the various treatment options available to patients and providers, there is an ever-growing need to implement evidence-based therapies.

Areas covered: The authors explore the different pharmacotherapies as commonly recommended in the American Urological Association (AUA) and European Association of Urology (EAU) multitiered guidelines for IC/BPS treatment as well as other investigational therapies. Pharmacotherapies targeting bladder, pelvic, and/or systemic factors in the overall treatment of IC/BPS are discussed with a particular focus on evidence-based guideline therapies. This article also looks at emerging therapies of interest.

Expert opinion: IC/BPS is a syndrome that requires a multimodal approach, including clinical phenotyping and directed therapy based on the patient's symptoms. The AUA and EAU provide guidelines for practitioners to follow, but adequate treatment requires the therapy to be targeted toward the patient's phenotypic domain.

Keywords: Bladder pain syndrome; interstitial cystitis; intravesical therapy.

Publication types

  • Review

MeSH terms

  • Amitriptyline / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Antidepressive Agents, Tricyclic / therapeutic use*
  • Cimetidine / therapeutic use
  • Cystitis, Interstitial / diagnosis
  • Cystitis, Interstitial / drug therapy*
  • Cystitis, Interstitial / pathology
  • Histamine Antagonists / therapeutic use
  • Humans
  • Hydroxyzine / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Pentosan Sulfuric Polyester / therapeutic use

Substances

  • Antibodies, Monoclonal
  • Antidepressive Agents, Tricyclic
  • Histamine Antagonists
  • Immunosuppressive Agents
  • Amitriptyline
  • Hydroxyzine
  • Pentosan Sulfuric Polyester
  • Cimetidine