OBJECTIVE: To quantify the extent and natural history of cystitis in relation to treatment with the non-steroidal anti-inflammatory drug (NSAID) tiaprofenic acid. METHODS: Anonymous postal questionnaires were sent to all UK and Irish consultant urologists enquiring about their awareness of the association between tiaprofenic acid (Surgam) and cystitis, and the number, nature and clinical details of patients with the diagnosis. RESULTS: Of the 357 urologists, 45.7% replied; 37.4% of those who responded had had cases of NSAID-concurrent cystitis, 35.6% replied that they had no personal experience but were aware of the possibility of an adverse drug reaction and 27% were unaware of the possibility of NSAID-related interstitial cystitis. There were 108 reported cases of cystitis; 55 (51%) were women, 12 (11%) were men and gender was not stated in 41 (38%). The median duration of treatment was 59 weeks (range 6 weeks-4 years). Symptoms abated completely on stopping the drug in 86% of patients, resolving in a median of 14 weeks (range 7 days-2 years). In seven cases (10%), resolution was incomplete; 17 patients had undergone reconstructive urological surgery. CONCLUSION: Tiaprofenic acid has caused at least 108 cases of cystitis and several of these patients underwent extensive urological surgery based on the assumption that they were suffering from chronic interstitial cystitis. Most cases were reversible on withdrawal of tiaprofenic acid, but 10% of patients had residual symptoms. Tiaprofenic acid causes a higher incidence of cystitis than any other NSAID and its withdrawal from the market should be considered.
OBJECTIVE: To quantify the extent and natural history of cystitis in relation to treatment with the non-steroidal anti-inflammatory drug (NSAID) tiaprofenic acid. METHODS: Anonymous postal questionnaires were sent to all UK and Irish consultant urologists enquiring about their awareness of the association between tiaprofenic acid (Surgam) and cystitis, and the number, nature and clinical details of patients with the diagnosis. RESULTS: Of the 357 urologists, 45.7% replied; 37.4% of those who responded had had cases of NSAID-concurrent cystitis, 35.6% replied that they had no personal experience but were aware of the possibility of an adverse drug reaction and 27% were unaware of the possibility of NSAID-related interstitial cystitis. There were 108 reported cases of cystitis; 55 (51%) were women, 12 (11%) were men and gender was not stated in 41 (38%). The median duration of treatment was 59 weeks (range 6 weeks-4 years). Symptoms abated completely on stopping the drug in 86% of patients, resolving in a median of 14 weeks (range 7 days-2 years). In seven cases (10%), resolution was incomplete; 17 patients had undergone reconstructive urological surgery. CONCLUSION:Tiaprofenic acid has caused at least 108 cases of cystitis and several of these patients underwent extensive urological surgery based on the assumption that they were suffering from chronic interstitial cystitis. Most cases were reversible on withdrawal of tiaprofenic acid, but 10% of patients had residual symptoms. Tiaprofenic acid causes a higher incidence of cystitis than any other NSAID and its withdrawal from the market should be considered.