Peters Kenneth M, Hasenau Deborah, Killinger Kim A, Chancellor Michael B, Anthony Michele, Kaufman Jonathan
Department of Urology, Beaumont Health System, 3535 W. 13 Mile Road Suite 438, Royal Oak, MI, 48073, USA.
Int Urol Nephrol. 2014 Dec;46(12):2291-5. doi: 10.1007/s11255-014-0828-5. Epub 2014 Sep 11.
Intravesical instillation of liposomes is a potentially new therapeutic option for subjects with interstitial cystitis/bladder pain syndrome (IC/BPS). The aim of this study was to explore the safety and clinical outcomes of 4 weekly instillations of sphingomyelin liposomes in an open-label cohort of subjects with IC/BPS.
Fourteen symptomatic IC/BPS subjects were treated with intravesical liposomes once a week for 4 weeks. Safety measurements included laboratory specimen collection, vital signs, post-void residual, and assessment of adverse events (AEs). Efficacy measurements included pain visual analog scales (VAS), voiding diaries, global response assessments (GRAs), and O'Leary-Sant Interstitial Cystitis Symptom and Problem Indices (ICSI and ICPI).
No treatment-related AEs were reported at any time over the course of the study. Urgency VAS scores significantly decreased at 4 weeks (p = 0.0029) and 8 weeks (p = 0.0112) post-treatment. Pain VAS scores significantly decreased at 4 weeks post-treatment (p = 0.0073). Combined ICSI and ICPI scores improved significantly at 4 and 8 weeks (p = 0.002 for both time points) post-treatment. Responses to GRA showed improvement at 4 weeks post-instillation. No significant decrease in urinary frequency was found.
Sphingomyelin liposome instillations were well tolerated in subjects with IC/BPS with no AEs attributed to the test article. Treatment was associated with improvements in pain, urinary urgency, and overall symptom scores. Placebo-controlled clinical trials are needed to assess this potential therapy for IC/BPS.
膀胱内灌注脂质体是间质性膀胱炎/膀胱疼痛综合征(IC/BPS)患者一种潜在的新治疗选择。本研究的目的是在一个开放标签的IC/BPS患者队列中探索每周4次鞘磷脂脂质体灌注的安全性和临床结果。
14名有症状的IC/BPS患者每周接受一次膀胱内脂质体治疗,共4周。安全性测量包括实验室标本采集、生命体征、排尿后残余尿量以及不良事件(AE)评估。疗效测量包括疼痛视觉模拟量表(VAS)、排尿日记、整体反应评估(GRA)以及奥利里-桑特间质性膀胱炎症状和问题指数(ICSI和ICPI)。
在研究过程中的任何时间均未报告与治疗相关的AE。治疗后4周(p = 0.0029)和8周(p = 0.0112)时,尿急VAS评分显著降低。治疗后4周时,疼痛VAS评分显著降低(p = 0.0073)。治疗后4周和8周时,ICSI和ICPI综合评分显著改善(两个时间点p均 = 0.002)。灌注后4周时,GRA反应显示有改善。未发现尿频有显著降低。
鞘磷脂脂质体灌注在IC/BPS患者中耐受性良好,未发现与试验药物相关的AE。治疗与疼痛、尿急和总体症状评分的改善相关。需要进行安慰剂对照临床试验来评估这种针对IC/BPS的潜在治疗方法。