The role of pentosan polysulfate in treatment approaches for interstitial cystitis

Abstract

Studies of the mechanisms and causes of interstitial cystitis (IC) and of the properties of pentosan polysulfate have provided a scientific rationale for using pentosan polysulfate to treat IC. In randomized, double-blind studies, patient and investigator evaluations of pentosan polysulfate in the treatment of IC resulted in favorable assessments of the drug. In addition, IC patients in two out of four randomized, prospective trials improved significantly in most variables with treatment by oral pentosan polysulfate; in the two other studies, the IC patients improved in some domains with pentosan therapy, although not significantly. Importantly, two longer-term, patient-evaluation studies showed that a longer duration of treatment with pentosan polysulfate resulted in greater improvements in patients' response rates and outcomes. The results indicate that treatment should be continued for 6 months or longer in order to show significant improvement. Of particular interest are studies suggesting that a potassium test may possibly predict the response of IC patients to treatment with pentosan polysulfate.

Figures

Figure 1

Dose-ranging study of pentosan polysulfate sodium for interstitial cystitis. Success is defined as >50% reduction in a patient’s overall rating of improvement of symptoms (PORIS).