Cyclosporine A found efficacious for refractory IC
Small study shows treatment associated with improvements in symptoms, QoL at 5 years
São Paulo, Brazil—Long-term cyclosporine A therapy may be an effective treatment option for refractory interstitial cystitis, say researchers from Brazil.
The authors report that cyclosporine A, 1.5 mg/kg twice per day given for 5 years, appears to produce clinically significant improvements in patient symptoms.
Researchers from the University of São Paulo Medical School, São Paulo, Brazil conducted a study with 45 IC patients (43 females and two males) who met the National Institute of Diabetes and Digestive and Kidney Diseases criteria for the diagnosis of IC. The primary purpose of the study was to analyze the impact of cyclosporine A on clinical and urodynamics outcomes at 5 years of follow-up.
All patients underwent cystoscopic examination, biopsy of the bladder, and urodynamic evaluation. The patients also kept a voiding diary. The authors measured symptoms before and after treatment using the O'Leary-Sant interstitial cystitis symptom index (ICSI) and interstitial cystitis problem index (ICPI). They assessed quality of life using the AUA QoL index, and all patients were evaluated before, during, and after treatment.
The authors found that the mean bladder capacity prior to treatment with cyclosporine A was 207 mL but increased to 318 mL after 5 years of follow-up. Additionally, the mean AUA QoL index went from 4.8 to 1.3 following 5 years of treatment.
“We were very pleased and very impressed with our results. It was very interesting to see how patients didn’t want to stop the trial. All of these patients had suffered a lot before and had already had multiple treatments that had failed,” said co-author Daher Chade, MD, attending physician in the division of urology at the University of São Paulo Medical School and former fellow at Memorial Sloan Kettering Cancer Center in New York.