CYCLOSPORINE IN SEVERE INTERSTITIAL CYSTITIS

Purpose: Cyclosporine is a widely used immunosuppressive drug in organ transplantation and recently it has been used in several autoimmune d isorders with good results. Because interstitial cystitis may have an autoimmune etiology, we wished to determine whether cyclosporine has a ny effect on symptoms in patients with severe interstitial cystitis. M aterials and Methods: A total of 11 patients, who fulfilled the criter ia for interstitial cystitis according to an international accrual for m, received cyclosporine for 3 to 6 months at an initial dose of 2.5 t o 5 mg./kg. daily and a maintenance dose of 1.5 to 3 mg./kg. daily. Bl ood pressure, serum creatinine and cyclosporine concentrations were mo nitored regularly. The patients completed frequency-volume charts at 2 -week intervals. Results: The frequency-volume charts showed favorable effects. Micturition frequency decreased (p <0.01), and mean and maxi mum voided volumes increased significantly (p <0.001 and p <0.01, resp ectively). Bladder pain decreased or disappeared in 10 patients, allow ing for storage of larger urine volumes. Serum creatinine did not chan ge with the dosages used. Mild hypertension occurred in 2 patients and resolved after the cyclosporine dose was lowered. After cessation of treatment symptoms recurred in the majority of patients. Conclusions: The findings revive the concept of interstitial cystitis as an autoimm une disease.