Effects of a short course of oral prednisolone in patients with bladder pain syndrome with fluctuating, worsening pain despite low-dose triple therapy - Abstract

PURPOSE: Triple therapy with gabapentin, amitriptyline, and nonsteroidal antiinflammatory drugs is efficacious for chronic bladder pain syndrome/interstitial cystitis (BPS/IC).

However, transient, fluctuating, worsening pain or flare-up symptoms may develop during treatment for a variety of reasons. Here, we assessed the validity of our observational experience regarding a short course of oral prednisolone therapy, which might be of value in the management of flare-up symptoms of BPS/IC.

METHODS: Between May 2007 and May 2012, 7 women (mean age, 61.5 years; range, 44.8 to 75.4 years) with BPS/IC presenting with transient, fluctuating, worsening pain as a flare-up symptom despite low-dose triple therapy received a 1- to 3-month course of oral prednisolone 10 mg. The outcome measures used were the IC symptom scale (ICSS, O'Leary-Sant Interstitial Cystitis Symptom Index) and a visual analogue scale (VAS), which were completed at baseline and after treatment.

RESULTS: There were statistically significant differences in the ICSS and VAS score before and after prednisolone treatment (P< 0.05 by Wilcoxon singed-rank test). The pretreatment IC symptom index (ICSI), IC problem index (ICPI), and VAS score were 16.7± 2.2, 13.7±2.3, and 8.3±1.5 (mean±standard deviation [SD]), and the posttreatment scores were 4.9±2.3, 4.3±1.1, and 2.5±0.9 (mean±SD), respectively. The ICSI, ICPI, and VAS scores were improved after prednisolone treatment by 70.7%, 68.6%, and 69.9%, respectively. Low-dose triple therapy with prednisolone caused no significant adverse effects.

CONCLUSIONS: In patients with BPS/IC who show transient, fluctuating, worsening pain as flare-up symptoms despite undergoing low-dose triple therapy, a short course of oral prednisolone therapy was sufficiently effective. However, large-scale studies should be performed to verify our findings.

Written by:
Jeong HJ.   Are you the author?
Department of Urology, Wonkwang University School of Medicine & Hospital, Iksan, Korea.

Reference: Int Neurourol J. 2012 Dec;16(4):175-80.
doi: 10.5213/inj.2012.16.4.175

PubMed Abstract
PMID: 23346483

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