Efficacy and safety of intravesical instillation of KRP-116D (50% dimethyl sulfoxide solution) for interstitial cystitis/bladder pain syndrome in Japanese patients: A multicenter, randomized, double-blind, placebo-controlled, clinical study.

Naoki Yoshimura, Yukio Homma, Hikaru Tomoe, Atsushi Otsuka, Takeya Kitta, Naoya Masumori, Yoshiyuki Akiyama, Aya Niimi, Takahiko Mitsui, Masaharu Nanri, Takashige Namima, Mineo Takei, Akito Yamaguchi, Yuki Sekiguchi, Mitsuru Kajiwara, Shinya Kobayashi, Kaname Ameda, Yozo Ohashi, Sadaaki Sakamoto, Osamu Muraki, Toshihide Shishido, Shinji Kageyama, Koji Kokura, Homare Okazoe, Tomonori Yamanishi, Toyohiko Watanabe, Takashi Uno, Akira Ohinata, Tomohiro Ueda
Author Information
  1. Naoki Yoshimura: Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
  2. Yukio Homma: Japanese Red Cross Medical Center, Tokyo, Japan.
  3. Hikaru Tomoe: Department of Pelvic Reconstructive Surgery/Urology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
  4. Atsushi Otsuka: Department of Urology, Hamamatsu University School of Medicine, Shizuoka, Japan.
  5. Takeya Kitta: Department of Renal and Genitourinary Surgery, Graduate School of Medical Science, Hokkaido University, Hokkaido, Japan.
  6. Naoya Masumori: Department of Urology, Sapporo Medical University School of Medicine, Hokkaido, Japan.
  7. Yoshiyuki Akiyama: Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  8. Aya Niimi: Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  9. Takahiko Mitsui: Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Yamanashi, Japan.
  10. Masaharu Nanri: Nanri Urological Clinic, Saga, Japan.
  11. Takashige Namima: Department of Urology, Tohoku Rosai Hospital, Miyagi, Japan.
  12. Mineo Takei: Department of Urology, Harasanshin Hospital, Fukuoka, Japan.
  13. Akito Yamaguchi: Department of Urology, Harasanshin Hospital, Fukuoka, Japan.
  14. Yuki Sekiguchi: Female Urology, Women's Clinic LUNA Next Stage, Kanagawa, Japan.
  15. Mitsuru Kajiwara: Department of Urology, Hiroshima Prefectural Hospital, Hiroshima, Japan.
  16. Shinya Kobayashi: Miyanosawa Nephrourological Clinic, Hokkaido, Japan.
  17. Kaname Ameda: Hokkaido Memorial Hospital of Urology, Hokkaido, Japan.
  18. Yozo Ohashi: Department of Urology, Japan Community Healthcare Organization Ritsurin Hospital, Kagawa, Japan.
  19. Sadaaki Sakamoto: Department of Urology, Nakamura Hospital, Oita, Japan.
  20. Osamu Muraki: Department of Urology, Fujita General Hospital, Fukushima, Japan.
  21. Toshihide Shishido: Department of Urology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
  22. Shinji Kageyama: Kageyama Urology Clinic, Shizuoka, Japan.
  23. Koji Kokura: Department of Urology, Takarazuka City Hospital, Hyogo, Japan.
  24. Homare Okazoe: Department of Urology, KKR Takamatsu Hospital, Kagawa, Japan.
  25. Tomonori Yamanishi: Department of Urology, Continence Center, Dokkyo Medical University, Tochigi, Japan.
  26. Toyohiko Watanabe: Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
  27. Takashi Uno: Clinical Development Center, Kyorin Pharmaceutical Co., Ltd., Tokyo, Japan.
  28. Akira Ohinata: Clinical Development Center, Kyorin Pharmaceutical Co., Ltd., Tokyo, Japan.
  29. Tomohiro Ueda: Department of Urology, Ueda Clinic, Kyoto, Japan.

Abstract

OBJECTIVE: To evaluate the efficacy and safety of intravesical KRP-116D, 50% dimethyl sulfoxide solution compared with placebo, in interstitial cystitis/bladder pain syndrome patients.
METHODS: Japanese interstitial cystitis/bladder pain syndrome patients with an O'Leary-Sant Interstitial Cystitis Symptom Index score of ≥9, who exhibited the bladder-centric phenotype of interstitial cystitis/bladder pain syndrome diagnosed by cystoscopy and bladder-derived pain, were enrolled. Patients were allocated to receive either KRP-116D (n = 49) or placebo (n = 47). The study drug was intravesically administered every 2 weeks for 12 weeks.
RESULTS: For the primary endpoint, the change in the mean O'Leary-Sant Interstitial Cystitis Symptom Index score from baseline to week 12 was -5.2 in the KRP-116D group and -3.4 in the placebo group. The estimated difference between the KRP-116D and placebo groups was -1.8 (95% confidence interval -3.3, -0.3; P = 0.0188). Statistically significant improvements for KRP-116D were also observed in the secondary endpoints including O'Leary-Sant Interstitial Cystitis Problem Index score, micturition episodes/24 h, voided volume/micturition, maximum voided volume/micturition, numerical rating scale score for bladder pain, and global response assessment score. The adverse drug reactions were mild to moderate, and manageable.
CONCLUSIONS: This first randomized, double-blind, placebo-controlled trial shows that KRP-116D improves symptoms, voiding parameters, and global response assessment, compared with placebo, and has a well-tolerated safety profile in interstitial cystitis/bladder pain syndrome patients with the bladder-centric phenotype.

Keywords

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Grants

  1. /Kyorin Pharmaceutical Co., Ltd,
  2. /National Institutes of Biomedical Innovation, Health and Nutrition

MeSH Term

Administration, Intravesical
Cystitis, Interstitial
Dimethyl Sulfoxide
Double-Blind Method
Humans
Japan
Treatment Outcome

Chemicals

Dimethyl Sulfoxide

Word Cloud

Created with Highcharts 10.0.0painKRP-116Dinterstitialsyndromeplacebocystitis/bladderscoresafetydimethylsulfoxidepatientsO'Leary-SantInterstitialCystitisIndexbladder-centricphenotyperandomizedintravesical50%solutioncomparedJapaneseSymptomstudydruggroup-33voidedvolume/micturitionbladderglobalresponseassessmentdouble-blindplacebo-controlledtrialOBJECTIVE:evaluateefficacyMETHODS:≥9exhibiteddiagnosedcystoscopybladder-derivedenrolledPatientsallocatedreceiveeithern = 49n = 47intravesicallyadministeredevery2 weeks12 weeksRESULTS:primaryendpointchangemeanbaselineweek12-524estimateddifferencegroups-1895%confidenceinterval-0P = 00188StatisticallysignificantimprovementsalsoobservedsecondaryendpointsincludingProblemmicturitionepisodes/24 hmaximumnumericalratingscaleadversereactionsmildmoderatemanageableCONCLUSIONS:firstshowsimprovessymptomsvoidingparameterswell-toleratedprofileEfficacyinstillationpatients:multicenterclinicalcystitiscontrolled

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