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Aims: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic inflammatory condition of the bladder. However, there are only a few medicines that are of pharmaceutical grade and reliably effective for IC/BPS symptoms. Choreito (CRT) is a pharmaceutical‐grade Kampo medicine and has been widely prescribed for patients of lower urinary tract symptoms (LUTS) and BPS in Japan. In this study, we exploratory investigated the effects of CRT on the IC/BPS‐like symptoms induced by tranilast. Methods: The rat IC/BPS‐like model was induced by feeding administration with 0.4% tranilast. The rats were divided into the three following treatment groups: normal diet (Normal), tranilast treatment (Control), and the groups of 1% CRT (CRT) treatment for IC/BPS‐like model. After 4 weeks, continuous cystmetry, locomotor, and vascular permeability was assessed. Furthermore, the cytokine levels in bladder were analyzed by the Bio‐Plex suspension array system and plasma monoamine were measured. Results: Control group exhibited 14.3% decrease of locomotor activity in the dark period, and which were 20.3% increase by 1%CRT treatment. The voiding interval was shorter in control than in other groups. 1%CRT suppressed the shortening of voiding interval. Evans blue leakage of bladder wall observed 44.8% higher in control group than in the normal group. The leakage of 1%CRT group was 33.3% less than in the control group. The cytokine level of IFNγ and VEGF were elevated in the control, and CRT treatment suppressed the elevation of IFNγ in the bladder. Plasma noradrenaline was significantly reduced by CRT treatment compared normal group. Conclusion: These results suggest that CRT can be an effective therapeutic agent for the treatment of IC/BPS‐like symptoms. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion Choreito (CRT) is a pharmaceutical‐grade Kampo medicine and has been widely prescribed for patients with lower urinary tract symptoms (LUTS) and cystitis in Japan. The purpose of this study was to investigate the efficacy and safety of CRT in patients with persisting bladder pain.This study was an open‐label, single‐arm exploratory study (Registration No. jRCTs071190017), and CRT was administered orally for eight weeks in addition to the standard therapy. The primary end‐point was the change in Core Lower Urinary Symptoms Score (CLSS) Q9 (bladder pain) from baseline to eight weeks after treatment. The secondary end‐points were all items of CLSS, International Prostate Symptom Score (IPSS), numerical rating scale of bladder pain, uroflowmetry, residual urine volume test, bladder diary and Overall Treatment Efficacy (OTE).In all, 13 female LUTS patients with bladder pain were enrolled. In the primary end‐point, CLSS Q9 (bladder pain) score significantly decreased at the point of week 8. Among secondary end‐points, IPSS Q7 (nocturia) has significantly decreased at weeks 4 and 8 compared with week 0. The numerical rating scale of bladder pain has significantly decreased at week 4. The 24‐hr urine volume significantly increased at week 8. However, no statistically significant changes in other subscores were observed. In satisfaction with CRT treatment according to OTE, 53.8% of patients reported “slightly improved.” There were no adverse drug reactions from CRT.We concluded that CRT has demonstrated therapeutic efficacy for bladder pain. CRT could be potentially a useful add‐on treatment for patients persisting with bladder pain. [ABSTRACT FROM AUTHOR]

B Cover b : The cover image is based on the Research Article I Choreito, a Kampo medicine attenuates detrusor overactivity and bladder pain symptoms in rat tranilast-induced interstitial cystitis/bladder pain syndrome-like model i by Yohei Tokita PhD et al., https://doi.org/10.1002/nau.25095. [Extracted from the article]