Cyclosporin A for Interstitial Cystitis

I had not researched Cyclosporin A for Interstitial cystitis prior so felt I should..

A decent article is:
Neurourology and Urodynamics Volume 26, Issue 2, pages 267–270, March 2007
Potassium sensitivity test (PST) as a measurement of treatment efficacy of painful bladder syndrome/interstitial cystitis: A prospective study with cyclosporine A and pentosan polysulfate sodium†
Jukka Sairanen1,*, Teuvo L. J. Tammela2, Mikael Leppilahti3, Markku Onali4, Tapio Forsell5, Mirja Ruutu  abstract here

  • 64 cases – 1/2 in each treatment
  • Cyclosporin A 1.5 mg/kg twice daily 0r Pentosan polysulfate 100 mg three times daily  -80% of responders were the cyclosporin A
    i.e. 24/32 cases of the cyslosporin A responded  = 75%
  • Responders would correspond to being “moderately better” or more –  a bit vague about what that meant though I can guess because maybe 2/3 had less than 10 voids/day and 3/4  had pain <5/10 (leaning on the group after that had a negative Potassium sensitivity test because actual separate data is not available). I have no idea what the pain levels were to start but obviously greater than 5/10.
  • Only about 10% of patients were smart enough to refuse a Potassium Sensitivity test after 6 month – Its use has waned for diagnosis now that one can do a bladder instillation of  buffered lidocaine  – whereby they can feel better rather than worse and it is therapeutic.

Comment – Cyclosporin A is an immunosuppressive. It is used in transplant cases where infections and kidney damage (especially in renal transplant cases) could become issues:
World Journal of Surgery Volume 10, Number 3, 348-360,
Complications of cyclosporin therapy
Barry D. Kahan, Stuart M. Flechner, Marc I. Lorber, Chris Jensen, Debbie Golden and Charles T. Van Buren  abstract here

I suspect it would not be sanctioned unless Intra-bladder treatments failed. It does, however, offer a newer option.

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