The cysteinyl leukotriene D4 receptor antagonist montelukast for the treatment of interstitial cystitis

J Urol. 2001 Nov;166(5):1734-7.

Abstract

Purpose: The presence of leukotriene D4 receptors in human detrusor myocytes and increased urinary leukotriene E4 in patients with interstitial cystitis and detrusor mastocytosis imply a role for cysteinyl containing leukotrienes as proinflammatory mediators in this disease. We examined the efficacy of the cysteinyl leukotriene 1 receptor antagonist montelukast for treating patients with interstitial cystitis and detrusor mastocytosis.

Materials and methods: Ten women in whom interstitial cystitis was diagnosed according to National Institute of Diabetes and Digestive and Kidney Diseases criteria and who also had detrusor mastocytosis with a minimum of 28 mast cells per mm.2 muscle tissue were included in this study. Patients received a single dose of montelukast daily for 3 months. The efficacy of treatment was determined by 24-hour urinary frequency, nocturia and pain using visual analog scales.

Results: After 1 month of montelukast treatment there was a statistically significant decrease in 24-hour urinary frequency, nocturia and pain which persisted during the 3 months of treatment. After 3 months 24-hour urinary frequency had decreased from 17.4 to 12 voidings (p = 0.009), nocturia had decreased from 4.5 to 2.8 (p = 0.019) and pain had decreased from 46.8 to 19.6 mm. on a visual analog scale (p = 0.006). No side effects were observed during treatment.

Conclusions: Montelukast treatment resulted in significant improvement in urinary frequency and pain. Its efficacy for decreasing urinary frequency and pain imply a role of leukotriene receptor antagonists for managing interstitial cystitis but further placebo controlled clinical studies are needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetates / therapeutic use*
  • Aged
  • Cystitis, Interstitial / drug therapy*
  • Humans
  • Leukotriene Antagonists / therapeutic use*
  • Male
  • Mastocytosis / drug therapy
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Quinolines / therapeutic use*
  • Urinary Bladder Diseases / drug therapy

Substances

  • Acetates
  • Leukotriene Antagonists
  • Quinolines
  • montelukast