1014: Hydroxyzine in interstitial cystitis – what is the best evidence?

J.A.B.Barros1, C.M.Neves2, J.P.F.G.Santos3
1 USF Maresia, ULS Matosinhos, Matosinhos, Portugal; 2 UCSP Senhora da Hora, ULS Matosinhos, Matosinhos, Portugal; 3 USF Lagoa, ULS Matosinhos, Matosinhos, Portugal
Objective: Interstitial cystitis (IC) is a chronic bladder condition, poorly known, disabling and worsened by ingestion of certain foods. IC affects mostly women aged between 30 and 70 years with an estimated prevalence of 2,5%. The diagnosis is clinical and one of exclusion. Treatment involves behavioural and hygiene-dietetic measures, pharmacological (including hydroxyzine) and surgical interventions. The purpose of this study is to review the available evidence on efficacy and safety of hydroxyzine in IC’s treatment in woman.
Methods: A search was conducted for clinical guidelines (CG), systematic reviews (SR), meta-analyses and randomized controlled trials in Medline, evidence-based medicine websites, the Index of Portuguese Medical Journals, and references of selected articles, published between January 2001 and December 2012, in English, Portuguese and Spanish languages, using the MeSH terms interstitial cystitis and hydroxyzine. The Strength Of Recommendation Taxonomy (SORT) scale of the American Family Physician was used for assigning levels of evidence (LE) and strength of recommendation (SR).
Results:72 articles were found and 3 were selected for this review: 2 CG, on the management of IC, recommends hydroxyzine as a standard therapy with a SR B; 1 SR considers hydroxyzine one of the best therapeutic options in IC (LE 2). The adverse event most frequently described was sedation.
Conclusions: The evidence reveals that hydroxyzine in symptomatic IC is an effective and safe therapy (SR B). Sedation is the most common adverse event, although not superior to placebo. Therefore, IC is a frequent and unknown condition, with a simple, safe and inexpensive treatment.

Disclosure: No conflict of interest declared