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The following is a summary of “Current updates relating to treatment for interstitial cystitis/bladder pain syndrome: systematic review and network meta-analysis,” published in the April 2024 issue of Urology by Park et al.
Despite numerous meta-analyses assessing therapeutic interventions for interstitial cystitis (IC) / bladder pain syndrome (BPS), a comprehensive review of treatment strategies still needs to be discovered. This study sought to thoroughly evaluate the efficacy of diverse therapies for IC/BPS and identify potential moderating factors through analysis of randomized controlled trials (RCTs).
A systematic search of PubMed, Cochrane, and Embase databases identified prospective RCTs meeting inclusion criteria: patients diagnosed with IC, interventions encompassing relevant treatments, comparisons against specified controls or placebos, and outcomes reported as mean differences for individual symptoms and structured questionnaires. Pairwise and network meta-analyses (NMA) were conducted to compare treatment modalities for IC/BPS, utilizing Hedges’ g standardized mean differences (SMDs) to assess improvements across outcomes. Efficacy measures included symptomatology such as pain, frequency, urgency, nocturia, and structured questionnaires evaluating IC/BPS symptoms.
The comprehensive literature search yielded 70 RCTs involving 3,651 patients. Pairwise meta-analysis revealed that certain treatments, particularly instillation and intravesical injection, exhibited statistically significant improvements in pain and urgency compared to control or placebo groups. However, no single treatment demonstrated significant enhancement across all measured outcomes in the NMA. Moderator analyses revealed associations between increasing age and elevated nocturia, as well as longer follow-up periods and reduced frequency.
This systematic review and meta-analysis shed light on the efficacy of diverse therapeutic approaches for IC. While certain interventions show promise in alleviating specific symptoms, a comprehensive treatment regimen combining multiple modalities may yield more favorable clinical outcomes for patients with IC, underscoring the complexity of managing this condition.
Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01485-w
