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Efficacy and safety of intravesical interferon instillation for women with refractory bladder pain syndrome/interstitial cystitis: A prospective study

Introduction & Objectives

Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a chronic and debilitating condition that can significantly diminish a patient’s quality of life. Despite extensive research, the precise causes and underlying mechanisms of IC remain elusive, leading to challenges in diagnosis and treatment. Researchers have proposed the role of viral infections in IC/BPS, with BK polyoma virus (BKPyV) and JCPyV detected in the urine of IC/BPS patients, which may be the original pathogen leading to the development of IC/BPS. Interferon, which involved in the antiviral response, can inhibit JCPyV and BKPyV infection. Therefore, interferon may be a potential therapy for IC/BPS. This study is the first to explore the efficacy and safety of interferon intravesical instillation for IC/BPS patients.

Materials & Methods


After local ethics committee approval was obtained, women diagnosed with IC/BPS in the absence of infection or tumor, and who meet inclusion and exclusion criteria were enrolled in this study from October 2022 to March 2023. Patients received weekly instillation of interferon alpha-2b injectio over a 4-week period, followed by monthly interferon instillations for the subsequent 4 months. The primary outcomes are 24-hour urinary frequency, times of nocturia, functional bladder capacity, global response assessment (GRA), ICSI, ICPI, and the visual analog scale (VAS). Adverse events were recorded.

Results


A total of 23 patients were included. Nobody withdrew the treatment. By month 6, a noteworthy reduction of 7.1 times was observed in the 24-hour voiding frequency, a decrease of 1.9 times in nocturia episodes, an increase of 47.4ml in functional bladder capacity, a reduction of 3.9 in ICSI, a decrease of 2.8 in ICPI, and a decrease of 3.2 in Pain VAS. There were no serious adverse events reported.
Table 1. Summary of demographic characteristics, and changes in efficacy variables from baseline to 6-month follow-up.

Conclusions

The rationale for exploring interferon therapy lies in the growing body of evidence suggesting viral involvement in IC/BPS. Our results suggest intravesical interferon therapy may be a potential effective and safe antiviral approaches for patients with IC/BPS.