Intravesical administration of combined hyaluronic acid (HA) and chondroitin sulfate (CS) for the treatment of female recurrent urinary tract infections: a European multicentre nested case–control study
| Autor: | Marian Bernat, Martin Romancik, Massimo Lazzeri, Manuel Di Biase, Oriana Ciani, Richard Lunik, Erik Arendsen, Elisabetta Costantini, Giuseppe Morgia, Rosanna Tarricone, Tomaskin Roman, Giorgio Guazzoni, Eugenia Fragalà |
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| Rok vydání: | 2016 |
| Předmět: |
Databases
Factual chondroitin sulphate 030232 urology & nephrology Gastroenterology chemistry.chemical_compound 0302 clinical medicine Recurrence Hyaluronic acid Medicine HEALTH SERVICES RESEARCH 030212 general & internal medicine INFECTIOUS DISEASE health care economics and organizations Antimicrobial Resistance Medicine (all) Chondroitin Sulfates CLINICAL TRIAL General Medicine Middle Aged Europe UROLOGY Administration Intravesical Treatment Outcome Urinary Tract Infections Drug Therapy Combination Female Adult medicine.medical_specialty UROLOGY HEALTH SERVICES RESEARCH INFECTIOUS DISEASE CLINICAL TRIAL Urinary system education Urogenital diseases 03 medical and health sciences Internal medicine Humans Chondroitin sulfate Aged Proportional Hazards Models Retrospective Studies business.industry Research Case-control study Retrospective cohort study Surgery Clinical trial chemistry Case-Control Studies Multivariate Analysis Nested case-control study Quality of Life business |
| Zdroj: | BMJ Open |
| ISSN: | 2044-6055 |
| Popis: | Objectives To compare the clinical effectiveness of the intravesical administration of combined hyaluronic acid and chondroitin sulfate (HA+CS) versus current standard management in adult women with recurrent urinary tract infections (RUTIs). Setting A European Union-based multicentre, retrospective nested case–control study. Participants 276 adult women treated for RUTIs starting from 2009 to 2013. Interventions Patients treated with either intravesical administration of HA+CS or standard of care (antimicrobial/immunoactive prophylaxis/probiotics/cranberry). Primary and secondary outcome measures The primary outcome was occurrence of bacteriologically confirmed recurrence within 12 months. Secondary outcomes were time to recurrence, total number of recurrences, health-related quality of life and healthcare resource consumption. Crude and adjusted results for unbalanced characteristics are presented. Results 181 patients treated with HA+CS and 95 patients treated with standard of care from 7 centres were included. The crude and adjusted ORs (95% CI) for the primary end point were 0.77 (0.46 to 1.28) and 0.51 (0.27 to 0.96), respectively. However, no evidence of improvement in terms of total number of recurrences (incidence rate ratio (95% CI), 0.99 (0.69 to 1.43)) or time to first recurrence was seen (HR (95% CI), 0.99 (0.61 to 1.61)). The benefit of intravesical HA+CS therapy improves when the number of instillations is ≥5. Conclusions Our results show that bladder instillations of combined HA+CS reduce the risk of bacteriologically confirmed recurrences compared with the current standard management of RUTIs. Total incidence rates and hazard rates were instead non-significantly different between the 2 groups after adjusting for unbalanced factors. In contrast to what happens with antibiotic prophylaxis, the effectiveness of the HA+CS reinstatement therapy improves over time. Trial registration number NCT02016118. |
| Databáze: | OpenAIRE |
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