Comparative safety review of current pharmacological treatments for interstitial cystitis/ bladder pain syndrome

Expert Opin Drug Saf. 2021 Sep;20(9):1049-1059. doi: 10.1080/14740338.2021.1921733. Epub 2021 May 19.

Abstract

Introduction: Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a frustrating disease of chronic bladder pain associated with lower urinary tract symptoms. Although there are many proposed treatment algorithms, the uncertainty as to their etiology has a negative impact on the therapeutic outcome. Oftentimes combination therapy of drugs with different mechanisms of action will be utilized to relieve the symptoms. With the various treatment options available to patients and providers, there is an ever-growing need to implement drug efficacy as well as safety to promote best practice in use of the approved drug.Areas covered: This review will focus on guideline-based pharmacotherapies as described by the AUA and EAU, specifically oral, and intravesical therapies with the most up-to-date published literature. Pharmacotherapies targeting bladder, and/or systemic factors in the overall treatment of IC/BPS are discussed with a particular focus on efficacy and drug safety evaluation.Expert opinion: IC/BPS is a syndrome that requires bladder targeting agents to restore the urothelium barrier function and inhibit bladder hypersensitivity as well as various drugs with anti-inflammatory effects, and immune modulation effects. Current pharmacotherapies for IC/BPS have various therapeutic effects and adverse effects depending on the dose and individual response.

Keywords: Interstitial cystitis; bladder pain syndrome; intravesical therapies; oral medications; safety.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Algorithms
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / adverse effects
  • Cystitis, Interstitial / drug therapy*
  • Cystitis, Interstitial / physiopathology
  • Drug Therapy, Combination
  • Humans
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / adverse effects
  • Lower Urinary Tract Symptoms / drug therapy*
  • Lower Urinary Tract Symptoms / etiology
  • Practice Guidelines as Topic

Substances

  • Anti-Inflammatory Agents
  • Immunologic Factors