Magazine article Drug Topics

IC Help

Magazine article Drug Topics

IC Help

Article excerpt

The Food & Drug Administration has approved a new heparin-like drug, pentosan polysulfate sodium (Elmiron, Baker Norton), as the first oral treatment for interstitial cystitis (IC), a mysterious and painful disease of the urinary bladder whose cause is unknown.

An estimated 700,000 Americans90% of them women-suffer from IC. But because of misdiagnosis, the number of cases may be even higher, according to Samuel Broder, M.D., v.p. and chief scientific officer of Ivax Corp., Miami, Fla. Ivax owns Baker Norton Pharmaceuticals, also of Miami.

"Anyone of any age can come down with interstitial cystitis," said Broder, who formerly directed the National Cancer Institute. "Patients we know of range in age from 14 to 90 years," he told reporters at a press conference announcing the drug's approval by the Food & Drug Administration.

Typically, patients describe their pelvic pain as like "razor blades-or glass splinters-moving around inside," he said. The patients must urinate some 50-60 times day and night. Some have committed suicide from despair over the pain and desolation of their lives.

The disease was described in medical texts as recently as 15 years ago as a rare disorder of hysterical postmenopausal women. With consistently negative cultures, sufferers often were advised to visit a psychiatrist. In fact, they usually visited at least five doctors over five years before receiving a correct diagnosis.

"Now physicians are taking the disease more seriously," said Vicki Ratner, M.D., an orthopedic surgeon and IC sufferer who founded the International Cystitis Association in 1984. "With $9 million a year in funding from the National Institutes of Health (NIH) for research into causes, diagnosis, and treatment, we're finally getting respect."

Broder thinks the cause is "a defect in the bladder lining, perhaps due to an autoimmune reaction ... resulting in inflammation that can lead to severe pain and frequency [of urination].... The bladder's fluid-holding capacity is drastically reduced."

But Robert Moldwin, M.D., a urologist and IC specialist from the Long Island (N.Y.) Jewish Medical Center, also at the press conference, suggested the symptoms are of neurogenic origin-that is, "neurons are secreting noxious substances that cause inflammation and stimulate pain."

Others say the culprit is an undetectable infection resistant to antibiotics. In fact, response to antibiotics rules out IC.

Diagnosis largely has consisted of eliminating other disorders. …

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