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间质性膀胱炎/膀胱疼痛综合征的患者相关结局:临床试验和普通泌尿外科实践的建议

Patient Related Outcomes for Interstitial Cystitis/Bladder Pain Syndrome Recommendations for Clinical Trials and General Urology Practice.

作者信息

Hayes Byron, Namugosa Mary, Evans Robert J, Hajebrahimi Sakineh, Janssen Dick, King Claudia, Pandey Sanjay, Curtis Nickel J

机构信息

Howard Hughes Medical Institute, Ashburn, Virginia, USA.

Department of Urology, Wake Forest University, Winston-Salem, NC, USA.

出版信息

Neurourol Urodyn. 2025 Sep;44(7):1455-1465. doi: 10.1002/nau.70107. Epub 2025 Jul 7.

Abstract

INTRODUCTION

The goal of this committee of the Interstitial Cystitis/Bladder Pain (IC/BPS) Consensus Group was to address the use of patient related outcomes (PROs) in IC/BPS.

METHODS

Priority areas of concern and related PICO (Population, Intervention, Comparison, Outcome) questions were addressed based on literature review, committee discussion and consensus group feedback. Consensus recommendations were developed regarding PROs and PRO Measures (PROMs) for the critical PICO questions.

RESULTS

PICO questions addressed 4 critical areas of concern: PROs, clinical trial primary endpoints, secondary endpoint PROMs and questionnaires for general practice management. The committee made 12 recommendations regarding outcomes in IC/BPS research and clinical practice.

DISCUSSION

The most important recommendation was the unmet need to develop and validate a better IC/BPS specific PRO, based on unbiased patient qualitative research methodology. At the present time, the Numerical Rating/VAS pain scales, voiding diaries and global response assessment are recommended for primary endpoint outcomes in clinical trials. The suggested composite IC/BPS specific PROM is the Genito Urinary Pain Index (GUPI) while the Interstitial Cystitis Symptom Index/Problem Index can be used for trial comparisons. If appropriate, generic PROMs that describe and measure pain, quality of life, sexual, and psychosocial parameters are suggested. Until a validated PRO is developed, the NIH GUPI or the Pain Urinary Frequency (PUF) questionnaire provides reasonable clinical evaluation of patients in standard urology practice.

CONCLUSION

PROMs are currently available for use in clinical trials and general practice, but more research is required to create better IC/BPS PRO-based outcome measures.

摘要

引言

间质性膀胱炎/膀胱疼痛综合征(IC/BPS)共识小组委员会的目标是探讨IC/BPS中患者相关结局(PROs)的应用。

方法

基于文献综述、委员会讨论和共识小组反馈,确定了优先关注领域及相关的PICO(人群、干预措施、对照、结局)问题。针对关键的PICO问题,制定了关于PROs和PRO测量工具(PROMs)的共识性建议。

结果

PICO问题涵盖了4个关键关注领域:PROs、临床试验主要终点、次要终点PROMs以及全科医疗管理问卷。委员会就IC/BPS研究和临床实践中的结局提出了12条建议。

讨论

最重要的建议是,基于无偏差的患者定性研究方法,开发并验证更好的IC/BPS特异性PRO的需求尚未得到满足。目前,数值评定/视觉模拟评分疼痛量表、排尿日记和整体反应评估被推荐用于临床试验的主要终点结局。建议的综合IC/BPS特异性PROM是泌尿生殖疼痛指数(GUPI),而间质性膀胱炎症状指数/问题指数可用于试验比较。如果合适,建议使用描述和测量疼痛、生活质量、性功能和心理社会参数的通用PROMs。在开发出经过验证的PRO之前,美国国立卫生研究院(NIH)的GUPI或疼痛排尿频率(PUF)问卷可为标准泌尿外科实践中的患者提供合理的临床评估。

结论

目前PROMs可用于临床试验和全科医疗,但需要更多研究来创建更好的基于IC/BPS PRO的结局测量工具。

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