A pilot clinical trial of oral pentosan polysulfate and oral hydroxyzine in patients with interstitial cystitis. 2003

G R Sant, and K J Propert, and P M Hanno, and D Burks, and D Culkin, and A C Diokno, and C Hardy, and J R Landis, and R Mayer, and R Madigan, and E M Messing, and K Peters, and T C Theoharides, and J Warren, and A J Wein, and W Steers, and J W Kusek, and L M Nyberg, and
New England Medical Center and Tufts University School of Medicine, Boston, MA, USA.

OBJECTIVE This pilot study was designed to evaluate the feasibility of a multicenter, randomized, clinical trial in interstitial cystitis (IC). Secondary objectives were to evaluate the safety and efficacy of oral pentosan polysulfate sodium (PPS), hydroxyzine, and the combination to consider their use in a larger randomized clinical trial. METHODS A 2 x 2 factorial study design was used to evaluate PPS and hydroxyzine. Participants met the National Institutes of Health-National Institute for Diabetes and Digestive and Kidney Diseases criteria for IC and reported at least moderate pain and frequency for a minimum of 6 months before study entry. The primary end point was a patient reported global response assessment. Secondary end points included validated symptom indexes and patient reports of pain, urgency and frequency. The target sample size was 136 participants recruited during 10 months. RESULTS A total of 121 (89% of goal) participants were randomized over 18 months and 79% provided complete followup data. The response rate for hydroxyzine was 31% for those treated and 20% for those not treated (p = 0.26). A nonsignificant trend was seen in the PPS treatment groups (34%) as compared to no PPS (18%, p = 0.064). There were no treatment differences for any of the secondary end points. Adverse events were mostly minor and similar to those in previous reports. CONCLUSIONS The low global response rates for PPS and hydroxyzine suggest that neither provided benefit for the majority of patients with IC. This trial demonstrated the feasibility of conducting a multicenter randomized clinical trial in IC using uniform procedures and outcomes. However, slow recruitment underscored the difficulties of evaluating commonly available IC drugs.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010426 Pentosan Sulfuric Polyester A sulfated pentosyl polysaccharide with heparin-like properties. Pentosan Polysulfate,Polypentose Sulfate,BAY-946,Elmiron,Fibrocid,HOE-946,HOE-BAY 946,HOE-BAY-946,Hemoclar,PZ-68,PZ68,Pentosan Polysulfate Sodium,Pentosan Polysulphate Sodium,Pentosane Sulfuric Polyester,Polysulfated Xylan,SP-54,Tavan SP 54,Xylan SP54,Xylan Sulfate,BAY 946,HOE 946,HOE BAY 946,PZ 68,Polyester, Pentosan Sulfuric,Polyester, Pentosane Sulfuric,Polysulfate Sodium, Pentosan,Polysulfate, Pentosan,Polysulphate Sodium, Pentosan,SP 54,SP 54, Tavan,SP54,SP54, Xylan,Sodium, Pentosan Polysulfate,Sodium, Pentosan Polysulphate,Sulfate, Polypentose,Sulfate, Xylan,Sulfuric Polyester, Pentosan,Sulfuric Polyester, Pentosane,Xylan, Polysulfated
D010865 Pilot Projects Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work. Pilot Studies,Pilot Study,Pilot Project,Project, Pilot,Projects, Pilot,Studies, Pilot,Study, Pilot
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D005240 Feasibility Studies Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project. Feasibility Study,Studies, Feasibility,Study, Feasibility
D005260 Female Females
D006634 Histamine H1 Antagonists Drugs that selectively bind to but do not activate histamine H1 receptors, thereby blocking the actions of endogenous histamine. Included here are the classical antihistaminics that antagonize or prevent the action of histamine mainly in immediate hypersensitivity. They act in the bronchi, capillaries, and some other smooth muscles, and are used to prevent or allay motion sickness, seasonal rhinitis, and allergic dermatitis and to induce somnolence. The effects of blocking central nervous system H1 receptors are not as well understood. Antihistamines, Classical,Antihistaminics, Classical,Antihistaminics, H1,Histamine H1 Antagonist,Histamine H1 Receptor Antagonist,Histamine H1 Receptor Antagonists,Histamine H1 Receptor Blockaders,Antagonists, Histamine H1,Antagonists, Histamine H1 Receptor,Antihistamines, Sedating,Blockaders, Histamine H1 Receptor,First Generation H1 Antagonists,H1 Receptor Blockaders,Histamine H1 Blockers,Receptor Blockaders, H1,Antagonist, Histamine H1,Classical Antihistamines,Classical Antihistaminics,H1 Antagonist, Histamine,H1 Antagonists, Histamine,H1 Antihistaminics,Sedating Antihistamines
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006919 Hydroxyzine A histamine H1 receptor antagonist that is effective in the treatment of chronic urticaria, dermatitis, and histamine-mediated pruritus. Unlike its major metabolite CETIRIZINE, it does cause drowsiness. It is also effective as an antiemetic, for relief of anxiety and tension, and as a sedative. 2-(2-(4-((4-Chlorophenyl)phenylmethyl)-1-piperazinyl)ethoxy)ethanol,Atarax,Durrax,Hydroxyzine Dihydrochloride,Hydroxyzine Hydrochloride,Hydroxyzine Pamoate,Orgatrax,Vistaril,Pamoate, Hydroxyzine

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