A randomized, open‐label, multicenter study of the efficacy and safety of intravesical hyaluronic acid and chondroitin sulfate versus dimethyl sulfoxide in women with bladder pain syndrome/interstitial cystitis

间质性膀胱炎 医学 透明质酸 膀胱疼痛综合征 泌尿科 硫酸软骨素 二甲基亚砜 打开标签 随机对照试验 内科学 泌尿系统 解剖 糖胺聚糖 有机化学 化学
作者
Mauro Cervigni,Monica Sommariva,R. Tenaglia,Daniele Porru,Edoardo Ostardo,Alessandro Giammò,Silvia Trevisan,Valeria Frangione,Oriana Ciani,Rosanna Tarricone,Giovanni Pappagallo
出处
期刊:Neurourology and Urodynamics [Wiley]
卷期号:36 (4): 1178-1186 被引量:59
标识
DOI:10.1002/nau.23091
摘要

AIMS Intravesical instillation of hyaluronic acid (HA) plus chondroitin sulfate (CS) in women with bladder pain syndrome/interstitial cystitis (BPS/IC) has shown promising results. This study compared the efficacy, safety, and costs of intravesical HA/CS (Ialuril ® , IBSA) to dimethyl sulfoxide (DMSO). METHODS Randomized, open‐label, multicenter study involving 110 women with BPS/IC. The allocation ratio (HA/CS:DMSO) was 2:1. Thirteen weekly instillations of HA (1.6%)/CS (2.0%) or 50% DMSO were given. Patients were evaluated at 3 (end‐of‐treatment) and 6 months. Primary endpoint was reduction in pain intensity at 6 months by visual analogue scale (VAS) versus baseline. Secondary efficacy measurements were quality of life and economic analyses. RESULTS A significant reduction in pain intensity was observed at 6 months in both treatment groups versus baseline ( P < 0.0001) in the intention‐to‐treat population. Treatment with HA/CS resulted in a greater reduction in pain intensity at 6 months compared with DMSO for the per‐protocol population (mean VAS reduction 44.77 ± 25.07 vs. 28.89 ± 31.14, respectively; P = 0.0186). There were no significant differences between treatment groups in secondary outcomes. At least one adverse event was reported in 14.86% and 30.56% of patients in the HA/CS and DMSO groups, respectively. There were significantly fewer treatment‐related adverse events for HA/CS versus DMSO (1.35% vs. 22.22%; P = 0.001). Considering direct healthcare costs, the incremental cost‐effectiveness ratio of HA/CS versus DMSO fell between 3735€/quality‐adjusted life years (QALY) and 8003€/QALY. CONCLUSIONS Treatment with HA/CS appears to be as effective as DMSO with a potentially more favorable safety profile. Both treatments increased health‐related quality of life, while HA/CS showed a more acceptable cost‐effectiveness profile.
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