a Department of Urology , Glickman Urologic and Kidney Institute, Cleveland Clinic , Cleveland , OH , USA.
Expert Opin Pharmacother. 2018 Jul;19(10):1097-1108. doi: 10.1080/14656566.2018.1491968. Epub 2018 Jul 4.
Interstitial cystitis (IC) and bladder pain syndrome (BPS) are chronic conditions that can be debilitating for patients. There is no consensus as to their etiology, and there are many proposed treatment algorithms. Oftentimes multimodal therapy, such as combining behavioral modification and physical therapy alongside pharmacotherapies, will be utilized. With the various treatment options available to patients and providers, there is an ever-growing need to implement evidence-based therapies.
The authors explore the different pharmacotherapies as commonly recommended in the American Urological Association (AUA) and European Association of Urology (EAU) multitiered guidelines for IC/BPS treatment as well as other investigational therapies. Pharmacotherapies targeting bladder, pelvic, and/or systemic factors in the overall treatment of IC/BPS are discussed with a particular focus on evidence-based guideline therapies. This article also looks at emerging therapies of interest.
IC/BPS is a syndrome that requires a multimodal approach, including clinical phenotyping and directed therapy based on the patient's symptoms. The AUA and EAU provide guidelines for practitioners to follow, but adequate treatment requires the therapy to be targeted toward the patient's phenotypic domain.
间质性膀胱炎(IC)和膀胱疼痛综合征(BPS)是两种会使患者身体虚弱的慢性疾病。目前还没有关于它们病因的共识,也有许多提议的治疗方案。通常情况下,会采用多模式治疗,例如将行为修正和物理疗法与药物治疗相结合。由于可供患者和提供者选择的治疗方案很多,因此越来越需要实施基于证据的治疗方法。
作者探讨了美国泌尿科协会(AUA)和欧洲泌尿外科学会(EAU)的 IC/BPS 治疗多梯次指南中常见推荐的不同药物治疗方法,以及其他正在研究的治疗方法。本文还探讨了针对膀胱、骨盆和/或全身因素的药物治疗方法,重点关注基于循证指南的治疗方法。本文还介绍了一些新兴的治疗方法。
IC/BPS 是一种需要多模式治疗的综合征,包括基于患者症状的临床表型和靶向治疗。AUA 和 EAU 为从业者提供了治疗指南,但要进行充分治疗,就需要将治疗方法针对患者的表型领域。