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GAG Therapy Safe and Effective in Patients with IC/BPS and Other Chronic Bladder Diseases

Lazzeri M, Hurle R, Casale P, Buffi N, Lughezzani G, Fiorini G, Peschechera R, Pasini L, Zandegiacomo S, Benetti A, Taverna G, Guazzoni G, Barbagli G. Managing chronic bladder diseases with the administration of exogenous glycosaminoglycans: an update on the evidence. Ther Adv Urol. 2016 Apr;8(2):91-9. doi: 10.1177/1756287215621234. Epub 2015 Dec 16.

While the cause of interstitial cystitis/bladder pain syndrome (IC/BPS) remains a topic for investigation, most researchers agree that the condition can arise from defects in the lining of the bladder, or more specifically, from damage to its component known as the glycosaminoglycan (GAG) layer. Thus, a number of therapeutic strategies for IC/BPS are focused on restoring or replenishing the GAG layer. This educational article offers a comprehensive review of the clinical use of GAG therapy in chronic bladder diseases including IC/BPS. In particular, exogenous GAGs have been applied as therapy for IC/BPS intravesically (i.e., directly to the bladder). While the studies are somewhat limited, the authors of this article say that the findings have confirmed that the combination of hyaluronic acid and chondroitin sulfate is safe and effective. In fact, exogenous GAGs seem to have an excellent safety profile with no significant adverse events. In the future, GAG therapy might be improved with oral formulations that could offer a noninvasive alternative, though data to support the use of these emerging oral therapies is not available yet.