810 CYCLOSPORINE A FOR REFRACTORY INTERSTITIAL CYSTITIS: EXPERIENCE OF TWO TERTIARY CENTERS

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Interstitial Cystitis1 Apr 2011810 CYCLOSPORINE A FOR REFRACTORY INTERSTITIAL CYSTITIS: EXPERIENCE OF TWO TERTIARY CENTERS John Forrest, Deborah Erickson, and Monica Cardona John ForrestJohn Forrest Tulsa, OK More articles by this author , Deborah EricksonDeborah Erickson Lexington, KY More articles by this author , and Monica CardonaMonica Cardona Tulsa, OK More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.628AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although many treatments are used for bladder pain syndrome/interstitial cystitis (BPS/IC), some patients remain debilitated. Cyclosporine A (CyA) was effective in a single-arm trial and was more effective than pentosan polysulfate in a randomized trial.1,2 Based on these reports, we offer CyA off-label to refractory IC patients. This is a retrospective review of our experience. METHODS Charts were reviewed with the IRB approval. At University of Kentucky (KU) and Urologic Specialists of Oklahoma, Inc, eligible patients had failed oral and/or instillation therapy Risks and off-label nature of the treatment were explained. Initial dose was 2 to 3 mg/kg/day divided into twice daily doses. Afer symptoms improved, dose was decreased gradually as tolerated. Dose also was adjusted based on side effects and serum CyA levels. The first visit was 1 month, then every 3 months, with symptom assessment, physical exam, comprehensive metabolic panel, complete blood count, serum magnesium, uric acid, and CyA levels. RESULTS Nineteen patients were evaluated including 12 women and 7 men with an age range of 44 to 71. Average follow up was 1 year. Fourteen of nineteen patients reported a 70% average global improvement in their symptoms. The remainder were non-responders or discontinued therapy early secondary to side effects including fatigue, muscle cramping, or lab abnormalities. Associated clinical findings include Hunner's ulcers in 13 of 19 patients and collagen vascular disease in 6 of 19 patients. CONCLUSIONS CyA was effective in the majorify of our refractory IC patients. Potential clinical markers to perdict a cyclosporine response include the presence of Hunner's ulcer or associated collagen vascular disease. CyA was generally well tolerated but requires careful monitoring.1,2 Sairanen, J J Urol 2005 and 2005 © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e326 Peer Review Report Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Forrest Tulsa, OK More articles by this author Deborah Erickson Lexington, KY More articles by this author Monica Cardona Tulsa, OK More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...