Interstitial Cystitis Pain Eases More With Intravesical Interferon vs Hyaluronic Acid – Renal and Urology News

Women with interstitial cystitis experience greater pain reduction with intravesical interferon therapy compared with intravesical hyaluronic acid, investigators report.

A virus may be the original pathogen leading to the development of interstitial cystitis, and studies have found associations with BK polyomavirus and JC virus, De-yi Luo, MD, PhD, of West China Hospital, Sichuan University in China, and colleagues noted. Interferon may promote an antiviral response to these infections.

In a double-blind randomized clinical trial of 52 Chinese women aged 18-70 years with interstitial cystitis (ClinicalTrials.gov Identifier: NCT05912946), pain intensity assessed by the visual analog scale decreased by a significant 1.3 points more at 6 months in patients receiving intravesical interferon, the investigators reported in JAMA Network Open. From baseline to 6 months, pain score had decreased 4.5 points in the intravesical interferon group compared with 3.6 points in the intravesical hyaluronic acid group. A greater proportion of patients receiving intravesical interferon experienced a 30% of more reduction in the visual analog scale score before and at 6 months (77% vs 46%). At baseline, similar proportions had Hunner ulcers (38% vs 35%).

Scores on the interstitial cystitis problem index and interstitial cystitis symptom index also decreased by a significant 3.0 and 2.5 points more, respectively, over 6 months in the interferon vs hyaluronic acid group. Along with patient-reported outcomes, an objective measure, moderate or greater improvement on the global response assessment, was reported by significantly more patients treated with interferon rather than hyaluronic acid (85% vs 54%). There were no significant differences between groups in 24-hour urinary frequency and functional bladder capacity.

The interferon group received installation of 1 mL of 300 international units recombinant human interferon alpha-2b injection with 40 mL sterile saline. The hyaluronic acid group received instillation of 40 mg of hyaluronic acid solution per 50 mL sterile saline. Patients received 4 weekly instillations, followed by monthly instillations for the subsequent 4 months.

The most common adverse events in both groups were bladder irritation and urinary infection that resolved or were successfully treated. One patient discontinued hyaluronic acid for poor effectiveness.

Previous pilot studies have investigated intravesical cidofovir, certolizumab pegol, and oral valacyclovir for these patients.

“This research underscores the potential benefits of antiviral approaches in [interstitial cystitis] management, which may improve patient care and quality of life,” according to Dr Luo’s team. “Further prospective multicenter evaluation is necessary to validate these findings.”