Factors associated with treatment outcomes after intravesical hyaluronic acid therapy in women with refractory interstitial cystitis: A prospective, multicenter study

doi:10.1097/JCMA.0000000000000498

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/23516

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/23516

Title:	Factors associated with treatment outcomes after intravesical hyaluronic acid therapy in women with refractory interstitial cystitis: A prospective, multicenter study
Authors:	Tsai, CP;Yang, JM;Liang, SJ;Lin, YH;Huang, WC;Lin, TY;Hsu, CS;Chuang, FC;Hung, MJ
Keywords:	Bladder pain syndrome;Hyaluronic acid;Interstitial cystitis;Intravesical therapy;Treatment outcome
Date:	2021
Issue Date:	2022-08-05T09:38:33Z (UTC)
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
ISSN:	1726-4901
Abstract:	Background: Bladder instillation of hyaluronic acid (HA) is an acceptable treatment for bladder pain syndrome/interstitial cystitis (BPS/IC). The treatment is limited by a high proportion of non-responders (similar to 30%-40%). Here, we aimed to evaluate predisposing factors associated with treatment outcomes. Methods: This is a prospective multicenter study. We enrolled a total of 137 (out of 140) women with refractory IC. They all underwent a standard protocol of 6-month intravesical HA therapy (initial 4 weeks, once weekly, followed by once monthly). To assess the outcomes, we used the pain Visual Analog Scale (Pain-VAS), Interstitial Cystitis Symptom and Problem Index (ICSI & ICPI), and a scaled Global Response Assessment (GRA). Results: The age of patients was 47.6 +/- 27.5 (range 24-77) years. We found statistically significant improvement (p < 0.001) in the Pain-VAS and the ICSI & ICPI scores both after the initial 4-weekly instillations and at the end of 6-month treatment. Those who reported moderate/marked improvement on GRA at the 2 follow-up visits were considered responders: 39.4% (n = 54) at the first follow-up, and 59.9% (n = 82) at the second follow-up. No remarkable side effect was noted. After statistical analyses, treatment outcomes on GRA were positively associated with baseline functional bladder capacity and with Pain-VAS scores. The initial treatment responses optimally (p < 0.001) predicted final treatment outcomes (McNemar). Conclusion: Intravesical HA therapy is safe and effective for most (similar to 60%) of our patients with refractory IC. Functional bladder capacity and Pain-VAS scores before treatment, and the early treatment responses are helpful predictors of treatment outcomes.
URI:	http://dx.doi.org/10.1097/JCMA.0000000000000498 https://www.webofscience.com/wos/woscc/full-record/WOS:000639297100013 https://ir.csmu.edu.tw:8080/handle/310902500/23516
Relation:	JOURNAL OF THE CHINESE MEDICAL ASSOCIATION ,2021,v84,issue 4, P418-422
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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