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Chondroitin Sulfate Treatment is Feasible, With Fewer Side Effects Than DMSO, in Women With IC/BPS

Tutolo M, Ammirati E, Castagna G, Klockaerts K, Plancke H, Ost D, Van der Aa F, De Ridder D. A prospective randomized controlled multicentre trial comparing intravesical DMSO and chondroïtin sulphate 2% for painful bladder syndrome/interstitial cystitis. Int Braz J Urol. 2016 Nov 2. doi: 10.1590/S1677-5538.IBJU.2016.0302. [Epub ahead of print]

In this randomized study, women with interstitial cystitis/bladder pain syndrome (IC/BPS) received either chondroïtin sulphate or dimethyl sulphoxide (DMSO). Both treatments were administered intravesically (ie, directly to the bladder via a catheter) weekly for a total of 6 weeks. However, of the 14 patients who started DMSO, only 6 completed the study; reasons they gave for dropping out included pain (during or after treatment administration), lack of efficacy, and the “intolerable” garlicky odor of DMSO. This high drop-out rate led the investigators to recommend that DMSO be “used with caution” and with active monitoring for adverse reactions. By contrast, the 22 patients in the chondroitin sulfate group reported moderate or marked improvement of IC/BPS much more often (73%, vs 14% for the DMSO group). In particular, the chondroitin sulfate-treated women more often reported reductions in pain, nighttime urination, and other measures. Ultimately, this trial was halted due to the high number of dropouts in the DMSO group, so more study will be needed to determine the relative benefit of these intravesical treatments for IC/BPS. However, this study does provide at least some additional evidence that chondroitin sulfate is likely a superior treatment choice of treatment when compared with DMSO. In September, Cervigni and colleagues reported a larger study of chondroitin sulfate versus DMSO (110 patients) in which women who received chondroitin sulfate given according to the planned treatment protocol had greater reductions in pain intensity, and fewer side effects, compared with women who received DMSO.