562 COULD HYALURONIC ACID REDUCE BACILLUS CALMETTE GUERIN (BCG) LOCAL SIDE EFFECTS? A PRELIMINARY REPORT

Abstract

You have accessJournal of UrologyBladder Cancer: Basic Research I1 Apr 2012562 COULD HYALURONIC ACID REDUCE BACILLUS CALMETTE GUERIN (BCG) LOCAL SIDE EFFECTS? A PRELIMINARY REPORT Enrico Finazzi Agro, Pierluigi Bove, Claudio Perugia, Giuseppe Vespasiani, Annalisa Maugliani, and Roberto Miano Enrico Finazzi AgroEnrico Finazzi Agro Rome, Italy More articles by this author , Pierluigi BovePierluigi Bove Rome, Italy More articles by this author , Claudio PerugiaClaudio Perugia Rome, Italy More articles by this author , Giuseppe VespasianiGiuseppe Vespasiani Rome, Italy More articles by this author , Annalisa MauglianiAnnalisa Maugliani Rome, Italy More articles by this author , and Roberto MianoRoberto Miano Rome, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.637AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Bacillus Calmette Guerin (BCG) is considered the most effective treatment to increase disease-free interval and reduce progression of non muscle invasive bladder cancer (NMIBC). Although considered safe, BCG can produce local side effects leading to treatment cessation or interruption. Hyaluronic acid (HA) has been used for the treatment of radiation and chemical cystitis. Aim of this preliminary study was to investigate if the co-administration of HA may reduce lower local side effects of BCG. METHODS 30 consecutive subjects undergoing BCG intravesical administration for high risk NMIBC were randomized (after informed consent) to receive BCG only (group A) or BCG and HA (group B). HA (Cystistat, Bioniche Pharma, Switzerland) was administered intravesically after every BCG administration, after BCG evacuation and bladder washing with saline. Patients were instructed to maintain HA in the bladder as long as possible after catheter removal. A 1 to 10 Visual Analog Scale (VAS) for bladder pain, International Prostate Symptom Score (IPSS ) and number of micturitions per day were evaluated in the two groups before and after six weekly BCG instillation. Patients were evaluated at three months by means of cystostopy and urine cytology. RESULTS Only one out of 30 (3,3%) patients in group A dropped out from the protocol, for local side effects. Results are reported in table 1. Three patient in group A and 4 in group B presented with recurrent pathology at three month follow up. Table 1. Group A Group B p Group A Group B p Group A Group B p Mean (SD) Pre-treatment Post-treatment Differences (post-pre) VAS (1-10) 4,5(2) 4,9(1,8) .56 5,8(1) 4,2(1,6) .04 1,5(0,7) −0,7(1,6) .0001 IPSS 13,9(4,4) 14,7(4,0) .60 17,5(2,6) 15,3(4) .10 3(3,5) 0,53(1,6) .02 Number of daily micturitions 10,3(2,2) 10,8(2,4) .53 11,5(1,3) 10,9(2,1) .44 1,23(1,7) 0,13(1) .04 CONCLUSIONS VAS for bladder pain was significantly lower after BCG administration in group B (patients treated with HA); IPSS and number of daily micturitions were not significantly lower in group B, but differences in their pre-post treatment change were significant. These very preliminary data seem to support a possible role of HA in reducing BCG local side effects. Nevertheless, randomized controlled trials should be performed before to draw any conclusion, even to exclude possible interferences of HA on BCG efficacy. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e230 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Enrico Finazzi Agro Rome, Italy More articles by this author Pierluigi Bove Rome, Italy More articles by this author Claudio Perugia Rome, Italy More articles by this author Giuseppe Vespasiani Rome, Italy More articles by this author Annalisa Maugliani Rome, Italy More articles by this author Roberto Miano Rome, Italy More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...