Oral methotrexate in the management of refractory interstitial cystitis

To establish the safety and efficacy of low-dose oral methotrexate in treat ing refractory interstitial cystitis, 9 women who fulfilled internationally accepted criteria for the diagnosis of interstitial cystitis were enrolled in a prospective study. All had proven unresponsive to conventional treatm ent modalities. Assessment by pain score and frequency volume charts was pe rformed pretreatment and up to 6 months during therapy. No significant adve rse side effects were noted. At the end of followup, 4 women had noted a su bjective improvement in bladder pain and wished to continue on methotrexate , 4 women noted little change and 1 woman reported a worsening of symptoms. Overall there was a significant reduction in pain score (p = 0.047) posttr eatment. However, there was no significant difference in urinary frequency per 24 hours (p = 0.40), maximum voided volume (p = 0.089) or mean voided v olume (p = 0.59). Methotrexate significantly improved bladder pain in women with interstitial cystitis, although no significant change was found in vo iding pattern.