Pharmacokinetic considerations for therapies used to treat interstitial cystitis

Barbara Gardella; Daniele Porru; Massimo Allegri; Stefano Bogliolo; Anna Daniela Iacobone; Cristina Minella; Rossella Elena Nappi; Simone Ferrero; Arsenio Spinillo

doi:10.1517/17425255.2014.896338

Pharmacokinetic considerations for therapies used to treat interstitial cystitis

Expert Opin Drug Metab Toxicol. 2014 May;10(5):673-84. doi: 10.1517/17425255.2014.896338. Epub 2014 Mar 12.

Authors

Barbara Gardella¹, Daniele Porru, Massimo Allegri, Stefano Bogliolo, Anna Daniela Iacobone, Cristina Minella, Rossella Elena Nappi, Simone Ferrero, Arsenio Spinillo

Affiliation

¹ University of Pavia, Fondazione IRCCS, Policlinico San Matteo, Department of Obstetrics and Gynecology , 19 Viale Camillo Golgi, 27100 Pavia , Italy +390382503722 ; +390382503885 ; [email protected].

PMID: 24621003
DOI: 10.1517/17425255.2014.896338

Abstract

Introduction: Interstitial cystitis (IC) or bladder pain syndrome (BPS) is defined as supra-pubic pain related to bladder filling. IC is characterized by a particular symptom complex with no identifiable causes; as with bladder hypersensitivity it is usually associated with urinary frequency and urgency with bladder pain. No current treatments have a significant impact on symptoms over time.

Areas covered: This systematic review examines the pharmacokinetic aspects and adverse event of present IC therapy to highlight appropriate treatment to improve the symptoms of IC. This article reviews material obtained via Medline, PubMed, and EMBASE literature searches up to October 2013.

Expert opinion: The correct approach to IC should consider a multidisciplinary team of specialists and a multimodal treatment package that include psychotherapy, behavior change, physical activation, and analgesic treatment. Unfortunately, a single therapeutic target for IC is not yet known. With regard to pathophysiology and therapy, there is more to discover. The first insult damages the bladder urothelium, hence vehicles that lead the drug to penetrate the wall of the bladder might be a novel strategic approach.

Publication types

Review
Systematic Review

MeSH terms

Administration, Intravesical
Anesthetics, Local / administration & dosage
Anesthetics, Local / adverse effects
Anesthetics, Local / pharmacokinetics*
Anesthetics, Local / therapeutic use
Animals
Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
Anti-Inflammatory Agents, Non-Steroidal / adverse effects
Anti-Inflammatory Agents, Non-Steroidal / pharmacokinetics*
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Antidepressive Agents, Tricyclic / administration & dosage
Antidepressive Agents, Tricyclic / adverse effects
Antidepressive Agents, Tricyclic / pharmacokinetics
Antidepressive Agents, Tricyclic / therapeutic use
Behavior Therapy
Combined Modality Therapy / adverse effects
Cystitis, Interstitial / immunology
Cystitis, Interstitial / metabolism
Cystitis, Interstitial / physiopathology
Cystitis, Interstitial / therapy*
Drug Therapy, Combination / adverse effects
Humans
Immunomodulation
Mast Cells / drug effects
Mast Cells / immunology
Mast Cells / metabolism
Pelvic Pain / etiology
Pelvic Pain / prevention & control
Psychotherapy
Urinary Bladder / drug effects*
Urinary Bladder / immunology
Urinary Bladder / metabolism
Urinary Bladder / physiopathology
Urothelium / drug effects
Urothelium / immunology
Urothelium / metabolism
Urothelium / physiopathology

Substances

Anesthetics, Local
Anti-Inflammatory Agents, Non-Steroidal
Antidepressive Agents, Tricyclic