New AUA guidelines shine spotlight on interstitial cystitis

Key Points

This year's AUA annual meeting will bring an important first for interstitial cystitis: AUA will be issuing guidelines for diagnosis and treatment.

"Pharmaceutical companies perceive a huge unmet need and a market that's bigger than had previously been thought," Philip M. Hanno, MD, MPH, professor of urology at the University of Pennsylvania, Philadelphia, told Urology Times.

"Monday [May 31] is going to be a big day for IC," Dr. Hanno said. The plenary session on that day will reflect these developments.

New monoclonal antibody

Leading off discussion about IC that day will be Robert Evans, MD, from Wake Forest University, Winston-Salem, NC, who will present late-breaking news about a promising new approach to treating IC pain with monoclonal antibodies. Dr. Evans is an investigator in the trials of Pfizer's tanezumab (RN624) for IC and will be presenting some data from preliminary trials of this monoclonal antibody against nerve growth factor. (Also see, "Agent shows early promise in relieving IC-related pain," http://www.urologytimes.com/tanezumab/).

Soon after that, IC experts will discuss how views of the syndrome are changing and what's happening to the terminology for the condition. Dr. Hanno and European urologists have proposed changing the now commonly used term IC/painful bladder syndrome to bladder pain syndrome, which they believe better reflects a focus on pain and pain treatment. In addition to diagnosis and treatment, the new guidelines may also address this terminology issue.

Only a short time later, Dr. Hanno will present the new guidelines at the plenary session. (If you want to get the news even earlier, visit the AUA pavilion in the Exhibit Hall on Saturday, May 29 at 2 pm.)

"They're going to be a starting point for where we are now, what we recommend, and where things may go. They're open to changes in the future as we get more knowledge," he said.

Updated data on physical therapy

Monday's podium session on IC also will also yield valuable treatment news for clinicians. Dr. Hanno made special note of the presentation of the National Institute of Diabetes and Digestive and Kidney Diseases-sponsored trial of physical therapy in women with IC. Its title is telling: "Randomized multicenter clinical trial shows efficacy of myofascial physical therapy in women with interstitial cystitis/painful bladder syndrome (PBS)."

It follows on the study, presented last year, of the feasibility of a trial of physical therapy for the high-tone pelvic floor muscle dysfunction often seen in IC. The cleverly designed trial proved to be one that could show whether this type of therapy has value, and now urologists will be learning just how valuable that therapy has been shown to be.

"When done according to the protocol in the study, it appears to be quite effective in improving symptoms, and it's something we can add to the armamentarium of treatment," said Dr. Hanno. He stressed the importance of having an experienced therapist to administer it, noting that the protocol is quite different from the type of pelvic floor physical therapy that has become the standard for problems related to low tone, such as incontinence.