Intravesical resiniferatoxin for the treatment of women with idiopathic detrusor overactivity and urgency incontinence: A single dose, 4 weeks, double‐blind, randomized, placebo controlled trial

Rios, Luis Augusto Seabra; Panhoca, Renato; Mattos, Demerval; Srugi, Miguel; Bruschini, Homero

doi:10.1002/nau.20300

Cited by 23 publications

(18 citation statements)

References 24 publications

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“…A single dose (50 nM RTX), placebo-controlled trial was performed in 58 patients with idiopathic detrusor overactivity and urgency incontinence (which would be considered idiopathic OAB) [119]. This trial failed to show a positive benefit of RTX.…”

Section: Urothelial Abnormalities In Nonneurogenic Idiopathic Oabmentioning

confidence: 99%

Evidence for Bladder Urothelial Pathophysiology in Functional Bladder Disorders

Keay

Birder

Chai

2014

BioMed Research International

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Understanding of the role of urothelium in regulating bladder function is continuing to evolve. While the urothelium is thought to function primarily as a barrier for preventing injurious substances and microorganisms from gaining access to bladder stroma and upper urinary tract, studies indicate it may also function in cell signaling events relating to voiding function. This review highlights urothelial abnormalities in bladder pain syndrome/interstitial cystitis (BPS/IC), feline interstitial cystitis (FIC), and nonneurogenic idiopathic overactive bladder (OAB). These bladder conditions are typified by lower urinary tract symptoms including urinary frequency, urgency, urgency incontinence, nocturia, and bladder discomfort or pain. Urothelial tissues and cells from affected clinical subjects and asymptomatic controls have been compared for expression of proteins and mRNA. Animal models have also been used to probe urothelial responses to injuries of the urothelium, urethra, or central nervous system, and transgenic techniques are being used to test specific urothelial abnormalities on bladder function. BPS/IC, FIC, and OAB appear to share some common pathophysiology including increased purinergic, TRPV1, and muscarinic signaling, increased urothelial permeability, and aberrant urothelial differentiation. One challenge is to determine which of several abnormally regulated signaling pathways is most important for mediating bladder dysfunction in these syndromes, with a goal of treating these conditions by targeting specific pathophysiology.

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Section: Urothelial Abnormalities In Nonneurogenic Idiopathic Oabmentioning

confidence: 99%

Evidence for Bladder Urothelial Pathophysiology in Functional Bladder Disorders

Keay

Birder

Chai

2014

BioMed Research International

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“…1). After a full-text review, the reasons for excluding reports were non-RCTs [4,26], other intervention interference [27,28], other similar diseases [9,29,30], and lack of desired outcome assessment [31]. The general characteristics of the studies included are presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Intravesical treatment for interstitial cystitis/painful bladder syndrome: a network meta-analysis

et al. 2016

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Introduction and hypothesis Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic inflammatory condition of the submucosal and muscular layers of the bladder. So far, there is no effective and targeted treatment strategy for IC/ PBS. This study aimed to assess the efficacy and safety of intravesical instillation treatment in IC/PBS patients. Methods We searched various databases up to October 2015. A network meta-analysis was performed to compare global response assessment (GRA) for different treatment strategies, including botulinum toxin A (BoNTA), bacillus CalmetteGuerin (BCG), resiniferatoxin (RTX), lidocaine, chondroitin sulfate (CS), oxybutynin, and pentosan polysulfate (PPS). A traditional meta-analysis was also performed. Results Sixteen trials evaluating 905 patients were included. Network meta-analysis indicated that BoNTA had the highest probability of being the best treatment course according to GRA assessment results (probability 81.7 %). BCG or BoNTA therapy yielded significant improvement in GRA incidence according to traditional meta-analysis. Patients who received PPS showed higher urinary frequency results compared with the placebo groups. BCG-and PPS-treated patients had elevated urinary urgency treatment effects compared with placebo groups. Bladder capacity restoration results also showed significant improvements in patients who received BoNTA compared with placebo-treated individuals. Conclusions These findings indicate that BoNTA therapy has the highest probability of being the best therapy according to GRA, and significantly improves bladder capacity in IC/PBS patients. BCG treatment also significantly increases the incidence of GRA and improves the symptoms of urinary urgency. PPS can significantly improve urinary frequency and urgency symptoms in IC/PBS patients.

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“…Intravesical RTX instillation in idiopathic detrusor overactivity has recently been studied [17,18]. Considering the shared pathogenesis of the mediation of C-fibers between idiopathic detrusor overactivity and PBS/IC, these studies remind us of RTX treatment.…”

Section: Discussionmentioning

confidence: 99%

Effects of Combination Treatment of Intravesical Resiniferatoxin Instillation and Hydrodistention in Patients with Refractory Painful Bladder Syndrome/Interstitial Cystitis: A Pilot Study

Ham

Kim

et al. 2012

Int Neurourol J

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PurposePainful bladder syndrome/interstitial cystitis (PBS/IC) is a disabling disease of the urinary bladder, and its etiology and treatment are not yet established. Current medications used in the treatment of PBS/IC have shown limited efficacy. This prospective study investigated the efficacy of intravesical resiniferatoxin (RTX) in PBS/IC refractory to medical treatment.MethodsPatients with proven PBS/IC refractory to traditional medical treatment were enrolled. By randomized trial, a total of 18 consecutive patients were divided into two groups: treatment with hydrodistention and intravesical RTX (group 1) or treatment with hydrodistension only (group 2). We assessed bladder pain by use of a visual analogue pain scale, the maximal urine flow rate, post-void residual urine volume, and a voiding diary before and 3 months after treatment.ResultsThe median age of the 18 patients was 55.8±6.9 years, and the median duration of symptoms before diagnosis was 3.6±1.6 years. Frequency, functional bladder capacity, and score on a 5-point pain scale were significantly improved at 3-month after treatment in both groups. Intravesical RTX instillation plus hydrodistention, compared with hydrodistention only, did not have a significant effect on the voiding symptoms or uroflowmetry of the patients but significantly improved scores on the pain scale.ConclusionsIntravesical RTX instillation plus hydrodistention was effective in relieving pain but was not effective in improving lower urinary tract symptoms. Further larger studies are needed to clarify the efficacy of combination treatment of intravesical RTX instillation and hydrodistention.

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Intravesical resiniferatoxin for the treatment of women with idiopathic detrusor overactivity and urgency incontinence: A single dose, 4 weeks, double‐blind, randomized, placebo controlled trial

Abstract: A single 50 nM intravesical dose of RTX was not better than placebo for the treatment of women with IDO and urgency incontinence.

Cited by 23 publications

References 24 publications

Evidence for Bladder Urothelial Pathophysiology in Functional Bladder Disorders

Evidence for Bladder Urothelial Pathophysiology in Functional Bladder Disorders

Intravesical treatment for interstitial cystitis/painful bladder syndrome: a network meta-analysis

Effects of Combination Treatment of Intravesical Resiniferatoxin Instillation and Hydrodistention in Patients with Refractory Painful Bladder Syndrome/Interstitial Cystitis: A Pilot Study

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