By Jill Heidi Osborne MA
Very interesting Botox study crossed my desk today. As you probably know, Botox A has been used for the treatment of various bladder conditions for several years now. Though it’s not approved specifically for the treatment of interstitial cystitis, it is a STEP FOUR treatment option in the AUA’s IC/BPS Treatment Guidelines. The treatment requires the injection of Botox A into the bladder wall, usually at 20 to 30 injection sites. The downside of Botox A treatment is that it can silence the nerves which control urination thus some (but not all) patients may be required to self catheterize for weeks or months afterward until the nerves become active again.
Well, in this study “Bladder Instillation of Liposome Encapsulated OnabotulinumtoxinA Improves Overactive Bladder Symptoms: A Prospective, Multicenter, Double-Blind, Randomized Trial”, researchers in Taiwan delivered liposomes filled BotoxA into the bladder via a simple bladder instillation and found the therapy safe and effective at reducing symptoms of overactive bladder (i.e. symptoms of frequency and intensity of urgency). Best of all, this study apparently experienced very few episodes of urinary retention that have made Botox treatment so worrying and challenging for patients.
Liposomes have been the subject of numerous IC studies by Dr. Michael Chancellor in previous years. A liposome is a small, hollow sphere made with a phospholipid. Empty liposomes have been shown to relieve symptoms of irritation in the bladder as well as provide some bladder mucosal protective effects. But, because liposomes are so easily absorbed into the bladder wall, liposomes can also be used to carry medications thus making this an exciting new drug delivery system. Dr. Eliot Lander is currently using liposomes to deliver elmiron deeper into the bladder wall with encouraging results.
Much of this research is made possible by Lipella Pharmaceuticals, a company that has worked for years to develop new treatments for IC, OAB, hemorrhagic cystitis and bladder cancer.
- Chuang Y, et al. “Bladder Instillation of Liposome Encapsulated OnabotulinumtoxinA Improves Overactive Bladder Symptoms: A Prospective, Multicenter, Double-Blind, Randomized Trial”, JUROL December 2014, Volume 192, Issue 6, Pages 1743–1749
- Lipella Pharmacuticals Press Release – December 15, 2014
- Lander EB, et al. Intravesical instillation of pentosan polysulfate encapsulated in a liposome nanocarrier for interstitial cystitis. Am J Clin Exp Urol. 2014 Jul 12;2(2):145-8.