Factors associated with treatment outcomes after intravesical hyaluronic acid therapy in women with refractory interstitial cystitis : A prospective, multicenter study
Copyright © 2021, the Chinese Medical Association..
BACKGROUND: Bladder instillation of hyaluronic acid (HA) is an acceptable treatment for bladder pain syndrome/interstitial cystitis (BPS/IC). The treatment is limited by a high proportion of non-responders (~30%-40%). Here, we aimed to evaluate predisposing factors associated with treatment outcomes.
METHODS: This is a prospective multicenter study. We enrolled a total of 137 (out of 140) women with refractory IC. They all underwent a standard protocol of 6-month intravesical HA therapy (initial 4 weeks, once weekly, followed by once monthly). To assess the outcomes, we used the pain Visual Analog Scale (Pain-VAS), Interstitial Cystitis Symptom and Problem Index (ICSI & ICPI), and a scaled Global Response Assessment (GRA).
RESULTS: The age of patients was 47.6 ± 27.5 (range 24-77) years. We found statistically significant improvement (p < 0.001) in the Pain-VAS and the ICSI & ICPI scores both after the initial 4-weekly instillations and at the end of 6-month treatment. Those who reported moderate/marked improvement on GRA at the 2 follow-up visits were considered responders: 39.4% (n = 54) at the first follow-up, and 59.9% (n = 82) at the second follow-up. No remarkable side effect was noted. After statistical analyses, treatment outcomes on GRA were positively associated with baseline functional bladder capacity and with Pain-VAS scores. The initial treatment responses optimally (p < 0.001) predicted final treatment outcomes (McNemar).
CONCLUSION: Intravesical HA therapy is safe and effective for most (~60%) of our patients with refractory IC. Functional bladder capacity and Pain-VAS scores before treatment, and the early treatment responses are helpful predictors of treatment outcomes.
Errataetall: |
CommentIn: J Chin Med Assoc. 2021 Apr 1;84(4):341-343. - PMID 33480631 |
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Medienart: |
E-Artikel |
Erscheinungsjahr: |
2021 |
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Erschienen: |
2021 |
Enthalten in: |
Zur Gesamtaufnahme - volume:84 |
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Enthalten in: |
Journal of the Chinese Medical Association : JCMA - 84(2021), 4 vom: 01. Apr., Seite 418-422 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Tsai, Ching-Pei [VerfasserIn] |
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Date Completed 17.12.2021 Date Revised 17.12.2021 published: Print CommentIn: J Chin Med Assoc. 2021 Apr 1;84(4):341-343. - PMID 33480631 Citation Status MEDLINE |
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doi: |
10.1097/JCMA.0000000000000498 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM323400124 |
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500 | |a Citation Status MEDLINE | ||
520 | |a Copyright © 2021, the Chinese Medical Association. | ||
520 | |a BACKGROUND: Bladder instillation of hyaluronic acid (HA) is an acceptable treatment for bladder pain syndrome/interstitial cystitis (BPS/IC). The treatment is limited by a high proportion of non-responders (~30%-40%). Here, we aimed to evaluate predisposing factors associated with treatment outcomes | ||
520 | |a METHODS: This is a prospective multicenter study. We enrolled a total of 137 (out of 140) women with refractory IC. They all underwent a standard protocol of 6-month intravesical HA therapy (initial 4 weeks, once weekly, followed by once monthly). To assess the outcomes, we used the pain Visual Analog Scale (Pain-VAS), Interstitial Cystitis Symptom and Problem Index (ICSI & ICPI), and a scaled Global Response Assessment (GRA) | ||
520 | |a RESULTS: The age of patients was 47.6 ± 27.5 (range 24-77) years. We found statistically significant improvement (p < 0.001) in the Pain-VAS and the ICSI & ICPI scores both after the initial 4-weekly instillations and at the end of 6-month treatment. Those who reported moderate/marked improvement on GRA at the 2 follow-up visits were considered responders: 39.4% (n = 54) at the first follow-up, and 59.9% (n = 82) at the second follow-up. No remarkable side effect was noted. After statistical analyses, treatment outcomes on GRA were positively associated with baseline functional bladder capacity and with Pain-VAS scores. The initial treatment responses optimally (p < 0.001) predicted final treatment outcomes (McNemar) | ||
520 | |a CONCLUSION: Intravesical HA therapy is safe and effective for most (~60%) of our patients with refractory IC. Functional bladder capacity and Pain-VAS scores before treatment, and the early treatment responses are helpful predictors of treatment outcomes | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Multicenter Study | |
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700 | 1 | |a Yang, Jenn-Ming |e verfasserin |4 aut | |
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700 | 1 | |a Lin, Yi-Hao |e verfasserin |4 aut | |
700 | 1 | |a Huang, Wen-Chu |e verfasserin |4 aut | |
700 | 1 | |a Lin, Tzu-Yin |e verfasserin |4 aut | |
700 | 1 | |a Hsu, Chun-Shuo |e verfasserin |4 aut | |
700 | 1 | |a Chuang, Fei-Chi |e verfasserin |4 aut | |
700 | 1 | |a Hung, Man-Jung |e verfasserin |4 aut | |
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