Journal article
Clinically Important Differences for Pain and Urinary Symptoms in Urologic Chronic Pelvic Pain Syndrome: A MAPP Network Study
The journal of urology, Vol.209(6), pp.1132-1140
06/2023
DOI: 10.1097/JU.0000000000003394
PMCID: PMC11062515
PMID: 36848118
Abstract
Symptom heterogeneity in interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome, collectively termed urologic chronic pelvic pain syndrome (UCPPS), has resulted in difficulty in defining appropriate clinical trial endpoints. We determine clinically important differences (CIDs) for 2 primary symptom measures, Pelvic Pain Severity (PPS) and Urinary Symptom Severity (USS), and evaluate subgroup differences.
The Multidisciplinary Approach to the Study of Chronic Pelvic Pain Symptom Patterns Study enrolled individuals with UCPPS. We defined CIDs by associating changes in PPS and USS over 3 to 6 months with marked improvement on a global response assessment using regression and receiver operating characteristic curves. We evaluated CIDs for absolute and percent change and examined differences in CIDs by sex-diagnosis, presence of Hunner lesions, pain type, pain widespreadness, and baseline symptom severity.
An absolute change of -4 was clinically important in PPS among all patients, but CID estimates differed by pain type, presence of Hunner lesions, and baseline severity. PPS CID estimates for percent change were more consistent across subgroups and ranged from 30 to 57 percent. The absolute change USS CID was -3 for female participants and -2 for male participants with CP/CPPS only. Patients with greater baseline severity required larger decreases in symptoms to feel improved. Estimated CIDs had lower accuracy among participants with low baseline symptoms.
A reduction of 30-50% in PSS is a clinically meaningful endpoint for future therapeutic trials in UCPPS. USS CIDs are more appropriately defined separately for male and female participants.
Details
- Title: Subtitle
- Clinically Important Differences for Pain and Urinary Symptoms in Urologic Chronic Pelvic Pain Syndrome: A MAPP Network Study
- Creators
- Alisa J Stephens-Shields - University of PennsylvaniaH Henry Lai - Washington University in St. LouisJ Richard Landis - University of PennsylvaniaKarl Kreder - University of IowaLarissa V Rodriguez - Weill Cornell MedicineBruce D Naliboff - University of California, Los AngelesNiloofar Afari - University of California San DiegoSiobhan Sutcliffe - Washington University in St. LouisRobert Moldwin - Hofstra UniversityJames W Griffith - Northwestern UniversityJ Quentin Clemens - University of MichiganCatherine S Bradley - University of IowaSusan Quallich - University of MichiganPriyanka Gupta - University of MichiganSteven E Harte - University of MichiganJohn T Farrar - University of Pennsylvania
- Resource Type
- Journal article
- Publication Details
- The journal of urology, Vol.209(6), pp.1132-1140
- DOI
- 10.1097/JU.0000000000003394
- PMID
- 36848118
- PMCID
- PMC11062515
- NLM abbreviation
- J Urol
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Language
- English
- Electronic publication date
- 02/27/2023
- Date published
- 06/2023
- Academic Unit
- Epidemiology; Obstetrics and Gynecology; Urology
- Record Identifier
- 9984375353102771
Metrics
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