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Immunosuppressive Treatment May Be Appropriate Treatment Option for IC/BPS

Wang Z, Zhang L. Treatment effect of cyclosporine A in patients with painful bladder syndrome/interstitial cystitis: A systematic review. Exp Ther Med. 2016 Jul;12(1):445-450. Epub 2016 Apr 27.
Cyclosporine A, an immunosuppressive drug, is used to prevent organ transplant rejection, and has been successfully used in a variety of ailments, such as psoriasis, rheumatoid arthritis, and hepatitis C. It’s also been the subject of multiple studies evaluating its effects in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). A number of the IC/BPS studies have suggested promising results, but it’s difficult to draw overall conclusions, because the studies have different parameters and are difficult to compare. To help provide some better insights, the authors of this article systematically reviewed as many high-quality studies as they could find in the medical literature. In sum, they looked at eight studies including a total of 298 patients. Three of the studies were randomized controlled trials (i.e., very rigorous studies); in those studies, the results suggested that cyclosporine A provided a better treatment effect compared with pentosan polysulfate sodium (Elmiron). While the treatment was generally well tolerated, cyclosporine A was associated with some adverse events, including increased blood pressure and elevated blood levels of creatinine, a waste product associated with kidney function. Despite the differences in the studies, the authors said the evidence overall supports the statement that cyclosporine A can produce long-term benefit in patients with IC/BPS. However, they did add that further studies will be needed to confirm the benefits.