Efficacy of Clorpactin in refractory bladder pain syndrome/interstitial cystitis: a randomized controlled trial

Cvach, Kristina; Rosamilia, Anna; Dwyer, Peter; Lim, Yujin; DeSouza, Alison; Ow, Linli; Thomas, Elizabeth; Murray, Christine; Leitch, Alison; Schierlitz, Lore

doi:10.1007/s00192-020-04652-3

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…In the first week posttreatment, three women in the clorpactin group presented to the emergency department and required admission for pain management. This study provides the most robust evidence for the use of clorpactin instillation in patients with BPS/IC [24 ▪ ].…”

Section: Intravesical Therapiesmentioning

confidence: 81%

“…Clorpactin is a hypochlorous acid derivative whose dilute solutions are germicidal, fungicidal and virucidal [22]. It was first used in BPS/IC in 1995, and it is thought to act by desensitization of bladder nociceptive nerve endings [23,24 ▪ ]. A multicentric, single-blinded RCT, enrolled 50 BPS/IC female patients refractory to oral medication.…”

Section: Intravesical Therapiesmentioning

confidence: 99%

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What is in the pipeline for new treatments for bladder pain syndrome/ interstitial cystitis?

Dias,

Mendes,

Oliveira

et al. 2024

Current Opinion in Urology

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Purpose of review Despite available treatments, many bladder pain syndrome/interstitial cystitis (BPS/IC) patients continue to have poor quality of life. Thus, there is an urge for new therapies. Our manuscript aims to review papers about BPS/IC treatments published in the last 2 years. Recent findings During this period, several treatments were tested, most of them new and others combining treatments already used. Pentosan polysulfate, interleukin 1 antagonist, low energy shock wave, physical therapy, hypnosis, acupuncture, clorpactin, dimethyl sulfoxide and hyaluronic acid plus botulinum toxin-A showed positive results. ASP3652 and lidocaine-releasing intravesical systems failed to prove their efficacy. Summary Validation of these studies is arduous due to the broad spectre of BPS/IC phenotypes, small number of patients enrolled, distinct outcome measures and short-term follow-up. It is also important to highlight that some authors combined therapies, and others split central and peripheric phenotypes before treatment. Therefore, soon, phenotyping and combining therapies with a step-by-step approach will be needed in BPS/IC treatment.

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Section: Intravesical Therapiesmentioning

confidence: 81%

Section: Intravesical Therapiesmentioning

confidence: 99%

What is in the pipeline for new treatments for bladder pain syndrome/ interstitial cystitis?

Dias,

Mendes,

Oliveira

et al. 2024

Current Opinion in Urology

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“…Of the 51 articles in MEDLINE, 7 focused on the treatment of HIC, including bladder instillation with dimethyl sulfoxide solution (DMSO), 68,69 triamcinolone acetonide, 70 tacrolimus, 71 bladder injection with human embryonic stem cell, 72 and the gold standard HIC treatment with fulguration of Hunner's lesion 73,74 . The other 18 studies focused on intravesical therapy of NHIC, including analysis and interpretation of published data showing cure of IC/BPS by uterosacral ligament repair, 75 clorpactin instillation, 76 intravesical hyaluronic acid (HA) instillation 77–79 or botulinum toxin‐A (BoNT‐A) injection 80–84 or combined treatment, 85 intravesical lidocaine instillation, 86,87 DMSO instillation, 88,89 intravesical injections of platelet‐rich plasma (PRP), 90 comparison of autonomic responses in different anesthesia types, 91 and stem cell treatment 92 . Results of most studies proved that BoNT‐A can decrease the exocytosis of proinflammatory and excitatory neurotransmitters and neuropeptides, such as substance P, from primary afferent fibers that transmit nociceptive pain and participate in the development of peripheral and central sensitizations and decreases the insertion of pain‐sensitive ion channels 93 .…”

Section: Current Treatment Modalities and Constructing Diagnostic And...mentioning

confidence: 99%

Multimodal therapies and strategies for the treatment of interstitial cystitis/bladder pain syndrome in Taiwan

Yu,

Kuo

2023

LUTS

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Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic disease characterized by bladder pain, frequency, and nocturia. The most common pathologies include chronic inflammation and bladder urothelium dysfunction. According to the bladder condition with or without Hunner's lesions, IC/BPS can be divided into “IC” in patients with Hunner's lesion (HIC) and “BPS” in those without Hunner's lesion (NHIC). Previous studies have reported greater central sensitization and interorgan cross‐talk in patients with NHIC. Multimodal treatments have been recommended in clinical guidelines under the biopsychosocial model. The bladder–gut–brain axis has also been speculated, and multimodal therapies are necessary. Unfortunately, currently, no treatment has been reported durable for IC/BPS. Patients with IC/BPS usually experience anxiety, depression, holistic physical responses, and even threats to social support systems. The lack of durable treatment outcomes might result from inadequate diagnostic accuracy and differentiation of clinical phenotypes based on the underlying pathophysiology. Precision assessment and treatment are essential for optimal therapy under definite IC/BPS phenotype. This article reviewed currently available literature and proposed a diagnosis and treatment algorithm. Based on bladder therapy combined with suitable physical and psychological therapies, a well‐grounded multimodal therapy and treatment algorithm for IC/BPS following a diagnostic protocol are indispensable.

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“…This study is a multi-centre, single-blinded randomized controlled trial [1] investigating the use of Clorpactin instillation in patients with refractory BPS/IC. This is particularly important owing to the current lack of good-quality evidence for the use of Clorpactin which, although reported to be effective in patients with BPS/IC since 1955, lacks controlled trials and is associated with caustic effects.…”

mentioning

confidence: 99%

Commentary: Efficacy of Clorpactin in refractory bladder pain syndrome/interstitial cystitis: a randomized controlled trial

Patel

2021

Int Urogynecol J

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Efficacy of Clorpactin in refractory bladder pain syndrome/interstitial cystitis: a randomized controlled trial

Cited by 4 publications

References 21 publications

What is in the pipeline for new treatments for bladder pain syndrome/ interstitial cystitis?

What is in the pipeline for new treatments for bladder pain syndrome/ interstitial cystitis?

Multimodal therapies and strategies for the treatment of interstitial cystitis/bladder pain syndrome in Taiwan

Commentary: Efficacy of Clorpactin in refractory bladder pain syndrome/interstitial cystitis: a randomized controlled trial

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