Condition

Interstitial Cystitis

Chronic bladder pain syndrome

120M
People Affected
60
Active Trials
3.6M
New Cases/Year
500
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Cyclosporine
70% Effectiveness• 65% Confidence• 35% Safety• 1 trials• 500 participants
MODERATE EvidencePoor ValueDose: 2.5-3.5 mg/kg/day
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Comparative Safety Scale(Higher is safer)

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35
DangerousModerateSafe

Time to Effect

1-3 months

Duration

6-12 months, or long-term if tolerated

Response Rate

70%

Remission Rate

15%

Common Side Effects:

Nephrotoxicity: 15%
Hypertension: 15%
Headache: 12%
Gingival hyperplasia: 8%
Increased infection risk: 7%

Annual Cost of Care

Drug Cost

$4,000

Monitoring

$2,400

Side Effects

$1,000

Total Annual

$7,400

Cost-Effectiveness

POOR

QALYs Gained

0.5

Cost per Remission

$49,333.33

Cost per Responder

$10,571.43

Treatment Outcomes
Primary Outcomes
Interstitial Cystitis Symptom Index (ICSI) Score28/45 points
-28.5% (-8 points)
Interstitial Cystitis Problem Index (ICPI) Score22/40 points
-31.8% (-7 points)
Pelvic Pain Visual Analog Scale (VAS)75/100 mm
-33.3% (-25 mm)
Nocturia Episodes per night4 episodes/night
-37.5% (-1.5 episodes/night)
Secondary Benefits
Interstitial Cystitis Quality of Life (ICQoL) Score45/100 points
+38.8% (+17.5 points)
Daytime Urinary Frequency18 voids/day
-33.3% (-6 voids/day)
Functional Bladder Capacity120 mL
+33.3% (+40 mL)
Common Side Effects
Nephrotoxicity
+15%
Hypertension
+15%
Headache
+12%

Clinical Trial Phases:

Phase 4
2
Sacral Neuromodulation (SNM)
68% Effectiveness• 80% Confidence• 68% Safety• 1 trials• 3K participants
HIGH EvidenceGood ValueDose: Programmable stimulation settings
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Comparative Safety Scale(Higher is safer)

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68
DangerousModerateSafe

Time to Effect

1-4 weeks (after activation)

Duration

Lifetime (device), 5-10 years (battery replacement)

Response Rate

60%

Remission Rate

10%

Common Side Effects:

Pain at implant site: 15%
Lead migration: 8%
Infection: 5%
Device malfunction: 7%
Revision surgery: 15%

Annual Cost of Care

Drug Cost

$0

Monitoring

$800

Side Effects

$500

Total Annual

$5,400

Cost-Effectiveness

GOOD

QALYs Gained

0.8

ICER

$70,000/QALY

Cost per Remission

$54,000

Cost per Responder

$9,000

Treatment Outcomes
Primary Outcomes
O'Leary-Sant Symptom Index Score15/20 points
-40% (-6 points)
O'Leary-Sant Problem Index Score13/16 points
-38% (-5 points)
Urinary Frequency18 voids/24h
-30% (-5.4 voids/24h)
Nocturia Episodes4.5 voids/night
-40% (-1.8 voids/night)
Secondary Benefits
Pelvic Pain Severity (VAS)7/10 on VAS scale
-40% (-2.8 points on VAS scale)
IC-Specific Quality of Life Score (ICQoL)50/100 points (higher is better)
+30% (+15 points)
Mean Volume Voided (Functional Bladder Capacity)120 mL
+30% (+36 mL)
Common Side Effects
Pain at implant site
+15%
Lead migration
+8%
Infection
+5%

Clinical Trial Phases:

Phase 3Phase 4
3
Dimethyl Sulfoxide (DMSO)
65% Effectiveness• 70% Confidence• 75% Safety• 5 trials• 2K participants
MODERATE EvidenceExcellent ValueDose: 50mL of 50% solution intravesically
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Comparative Safety Scale(Higher is safer)

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Meth💀
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75
DangerousModerateSafe

Time to Effect

1-4 weeks

Duration

6-8 weeks induction, then maintenance

Response Rate

55%

Remission Rate

5%

Common Side Effects:

Garlic-like body odor: 80%
Bladder discomfort: 40%
Bladder irritation: 15%

Annual Cost of Care

Drug Cost

$0

Monitoring

$500

Side Effects

$0

Total Annual

$6,800

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.3

ICER

$11,353/QALY

Cost per Remission

$136,000

Cost per Responder

$12,363.64

Treatment Outcomes
Primary Outcomes
Pelvic Pain Score (VAS)VAS score: 7/10
-35% (-2.45 points)
Urinary Frequency (24-hour)18 micturitions/24h
-25% (-4.5 micturitions/24h)
Nocturia Episodes4 episodes/night
-40% (-1.6 episodes/night)
Urgency Score (0-10 scale)Urgency score: 8/10
-35% (-2.8 points)
Secondary Benefits
Interstitial Cystitis Symptom Index (ICSI) Total ScoreICSI score: 28/36
-25% (-7 points)
Interstitial Cystitis Problem Index (ICPI) Total ScoreICPI score: 30/40
-25% (-7.5 points)
Interstitial Cystitis Quality of Life (ICQoL) ScoreICQoL score: 40/100
+20% (+8 points)
Common Side Effects
Garlic-like body odor
+80%
Bladder discomfort
+40%
Bladder irritation
+15%

Clinical Trial Phases:

Phase 4
4
Heparin/Lidocaine (intravesical)
62% Effectiveness• 68% Confidence• 75% Safety• 8 trials• 1.5K participants
MODERATE EvidenceGood ValueDose: Heparin 10,000-20,000 units + Lidocaine 1-2% 20mL intravesically
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Comparative Safety Scale(Higher is safer)

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Meth💀
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75
DangerousModerateSafe

Time to Effect

Immediate (Lidocaine), 2-4 weeks (Heparin)

Duration

6-12 weeks induction, then maintenance

Response Rate

50%

Remission Rate

3%

Common Side Effects:

Bladder discomfort: 30%
Urgency: 15%

Annual Cost of Care

Drug Cost

$0

Monitoring

$500

Side Effects

$50

Total Annual

$6,850

Cost-Effectiveness

GOOD

QALYs Gained

0.25

Cost per Remission

$228,333.33

Cost per Responder

$13,700

Treatment Outcomes
Primary Outcomes
Bladder Pain Score (NRS)7/10
-42.9% (-3 points)
O'Leary-Sant Symptom Index (ICSI)12/16
-33.3% (-4 points)
Nocturnal Voids3.5 voids/night
-42.9% (-1.5 voids/night)
Secondary Benefits
O'Leary-Sant Problem Index (ICPI)10/16
-30% (-3 points)
Maximum Voided Volume150 mL
+33.3% (+50 mL)
Common Side Effects
Bladder discomfort
+30%
Urgency
+15%

Clinical Trial Phases:

Phase 4
5
Amitriptyline
60% Effectiveness• 75% Confidence• 58% Safety• 3 trials• 4K participants
MODERATE EvidenceGood ValueDose: 10-100mg daily
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Comparative Safety Scale(Higher is safer)

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Meth💀
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58
DangerousModerateSafe

Time to Effect

4-8 weeks

Duration

Lifetime

Response Rate

45%

Remission Rate

5%

Number Needed to Treat (NNT)

4

Common Side Effects:

Dry mouth: 40%
Drowsiness: 30%
Constipation: 15%
Weight gain: 15%
Dizziness: 12%

Annual Cost of Care

Drug Cost

$200

Monitoring

$500

Side Effects

$100

Total Annual

$800

Cost-Effectiveness

GOOD

QALYs Gained

0.5

ICER

$52,865/QALY

Cost per Remission

$16,000

Cost per Responder

$1,777.78

Treatment Outcomes
Primary Outcomes
Global Response Assessment (GRA)74 Participants
-18% (-13.0 Participants)
Secondary Benefits
Changes in Quality of Life Measures From Baseline to 12 Weeks
0%
Change in Urinary Symptoms Measures
0%
Adherence to Study Drug and Urinary Educational/Behavioral Program (EBMP Educational/Behavioral Modification Program)62 Participants
-56% (-35.0 Participants)
Common Side Effects
Dry mouth
+40%
Drowsiness
+30%
Constipation
+15%

Clinical Trial Phases:

Phase 4
6
Pentosan Polysulfate Sodium
55% Effectiveness• 65% Confidence• 58% Safety• 3 trials• 5K participants
MODERATE EvidenceModerate ValueDose: 100mg three times daily
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Comparative Safety Scale(Higher is safer)

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58
DangerousModerateSafe

Time to Effect

3-6 months

Duration

Lifetime

Response Rate

35%

Remission Rate

5%

Number Needed to Treat (NNT)

8

Common Side Effects:

Nausea: 8%
Diarrhea: 7%
Alopecia: 4%
Headache: 4%
Maculopathy: 1%

Annual Cost of Care

Drug Cost

$54,000

Monitoring

$1,150

Side Effects

$200

Total Annual

$55,350

Cost-Effectiveness

MODERATE

QALYs Gained

0.3

ICER

$112,654/QALY

Cost per Remission

$1,107,000

Cost per Responder

$158,142.86

Treatment Outcomes
Primary Outcomes
ICSI Score (O'Leary-Sant Interstitial Cystitis Symptom Index)15 points (scale 0-30)
-20% (-3 points)
Pelvic Pain Severity (Numeric Rating Scale)7/10
-21.4% (-1.5/10)
Urinary Frequency (24-hour voiding diary)18 voids/24 hours
-16.7% (-3 voids/24 hours)
Secondary Benefits
ICPI Score (O'Leary-Sant Interstitial Cystitis Problem Index)10 points (scale 0-20)
-20% (-2 points)
Nocturia (awakenings per night)4 awakenings/night
-25% (-1 awakening/night)
Average Voided Volume100 mL
+15% (+15 mL)
Common Side Effects
Nausea
+8%
Diarrhea
+7%
Alopecia
+4%

Clinical Trial Phases:

Phase 3Phase 4
7
Hydroxyzine
45% Effectiveness• 60% Confidence• 78% Safety• 20 trials• 1K participants
LOW EvidenceExcellent ValueDose: 10-50mg daily
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Comparative Safety Scale(Higher is safer)

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78
DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

Lifetime

Response Rate

30%

Remission Rate

2%

Common Side Effects:

Drowsiness: 25%
Dry mouth: 15%
Dizziness: 7%

Annual Cost of Care

Drug Cost

$100

Monitoring

$500

Side Effects

$50

Total Annual

$650

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.2

ICER

$10,147/QALY

Cost per Remission

$32,500

Cost per Responder

$2,166.67

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+45%
Response Rate
+30%
Remission Rate
+2%
Common Side Effects
Drowsiness
+25%
Dry mouth
+15%
Dizziness
+7%

Clinical Trial Phases:

Phase 4