Systemic Therapy for Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC): Systematic Review of Published Trials in the Last 5 Years
2020
Systemic drug therapy licensed and present in worldwide guidelines for bladder pain syndrome/interstitial cystitis (BPS/IC) has been relatively stable for the last years. This systematic review aims to assess trials enrolling BPS/IC patients, published in the last 5 years. The authors abided by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement to define retrieved trials. The keywords used in the search were “interstitial cystitis”, “bladder pain syndrome” and “trial”. Five additional papers were added: three published before 2015, due to the added value to the present work, and two published in abstract form only, retrieved from previous systematic reviews. The pursuit of better and novel treatment modalities for BPS/IC patients is constant. Different classes of drugs were tried as potential systemic therapy in BPS/IC patients. Among retrieved trials, positive results were reported with sildenafil, certolizumab, amitriptyline, gefapixant, and cyclosporine A. Other drugs failed to prove their efficacy. When using other licensed drugs for BPS/IC, several trials showed inconclusive results or failed to meet the criteria at interim analyses. The interpretation of BPS/IC trial results is not straightforward especially when compared to other pathologies, due to difficulty in characterizing and phenotyping patients. Overall, both positive and inconclusive trials should motivate peers to continue the search for novel therapies in this condition. Trials with better designs and with a larger number of individuals are needed.
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