Evidence map›Paper›PMID 27033958›Full record

Observational studyBMJ open2016

Intravesical administration of combined hyaluronic acid (HA) and chondroitin sulfate (CS) for the treatment of female recurrent urinary tract infections: a European multicentre nested case-control study.

Oriana Ciani, Erik Arendsen, Martin Romancik, Richard Lunik, Elisabetta Costantini, Manuel Di Biase, Giuseppe Morgia, Eugenia Fragalà, Tomaskin Roman, Marian Bernat and 3 more

2 registry-linked trialsOpen access · goldAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 25 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 3 pooled it
8.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02016118 unknown statusnot on this map

INTRAVESICAL ADMINISTRATION OF COMBINED HYALURONIC ACID (HA) AND CHONDROITIN SULPHATE (CS) vs. STANDARD OF CARE FOR THE TREATMENT OF RECURRENT URINARY TRACT INFECTIONS (RUTIs)

TypeobservationalSponsorStudy Group for Urogenital Diseases, ItalyRan2014 to 2014Enrolled500ConditionsRecurrent Urinary Tract InfectionsArmsIaluril
NCT03633994 phase2unknown statusnot on this mapstarted 2018, after this paper: background citation

Heparin Intraoperative Instillation for Lower Urinary Tract Symptoms After Benign Hysterectomy: A Randomized Controlled Trial

TypeinterventionalSponsorThe Christ HospitalRan2018 to 2020Enrolled104ConditionsLower Urinary Tract Symptoms, Postoperative Urinary Tract InfectionArmsHeparin, Normal saline
3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 65 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Review
  6. Review
  7. Effects of hyaluronic acid and chondroitin sulfate on acute radiation proctitis in rats.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2023
    Article
  8. Review
  9. Review
  10. Article
  11. Heterologous production of chondroitin.Biotechnology reports (Amsterdam, Netherlands) · 2022
    Review
  12. Article
  13. Observational
  14. Review
  15. The Protective Influence of Chondroitin Sulfate, a Component of Human Milk, on Intestinal Bacterial Invasion and Translocation.Journal of human lactation : official journal of International Lactation Consultant Association · 2019
    Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 4 countries.

Oriana CianiCentre for Research on Health and Social Care Management, Università Bocconi, Milan, Italy Evidence Synthesis & Modelling for Health Improvement, Institute of Health Research, University of Exeter Medical School, Exeter, UK.
Erik ArendsenDiaconessenhuis, Maatschap, Urologie, Leiden, The Netherlands.
Martin RomancikDepartment of Urology, St. Cyril and Method University Hospital, Bratislava, Slovakia.
Richard LunikDepartment of Urology, Fakultná nemocnica s poliklinikou, Prešov, Slovakia.
Elisabetta CostantiniDepartment of Surgical and Biomedical Science, University of Perugia, Urology and Andrology Clinic, Perugia, Italy.
Manuel Di BiaseDepartment of Surgical and Biomedical Science, University of Perugia, Urology and Andrology Clinic, Perugia, Italy.
Giuseppe MorgiaDepartment of Urology, University of Catania, Catania, Italy.
Eugenia FragalàDepartment of Urology, University of Catania, Catania, Italy.
Tomaskin RomanDepartment of Urology, Jessenius School of Medicine, University Hospital, Martin, Slovakia.
Marian BernatFNsP, Urologicka Klinika, Nové Zámky, Slovakia.
Giorgio GuazzoniDepartment of Urology, Humanitas Clinical and Research Center, Milan, Italy.
Rosanna TarriconeCentre for Research on Health and Social Care Management, Università Bocconi, Milan, Italy Department of Policy Analysis and Public Management, Università Bocconi, Milano, Italy.
Massimo LazzeriDepartment of Urology, Humanitas Clinical and Research Center, Milan, Italy.
Bocconi University · ITHumanitas University · ITUniversity of Catania · ITUniversity of Perugia · ITComenius University Bratislava · SKDetská Fakultná Nemocnica s Poliklinikou · SKDiakonessenhuis hospital · NLMartin University Hospital · SK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo compare the clinical effectiveness of the intravesical administration of combined hyaluronic acid and chondroitin sulfate (HA+CS) versus current standard management in adult women with recurrent urinary tract infections (RUTIs).

settingA European Union-based multicentre, retrospective nested case-control study.

participants276 adult women treated for RUTIs starting from 2009 to 2013.

interventionsPatients treated with either intravesical administration of HA+CS or standard of care (antimicrobial/immunoactive prophylaxis/probiotics/cranberry). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was occurrence of bacteriologically confirmed recurrence within 12 months. Secondary outcomes were time to recurrence, total number of recurrences, health-related quality of life and healthcare resource consumption. Crude and adjusted results for unbalanced characteristics are presented.

results181 patients treated with HA+CS and 95 patients treated with standard of care from 7 centres were included. The crude and adjusted ORs (95% CI) for the primary end point were 0.77 (0.46 to 1.28) and 0.51 (0.27 to 0.96), respectively. However, no evidence of improvement in terms of total number of recurrences (incidence rate ratio (95% CI), 0.99 (0.69 to 1.43)) or time to first recurrence was seen (HR (95% CI), 0.99 (0.61 to 1.61)). The benefit of intravesical HA+CS therapy improves when the number of instillations is ≥ 5.

conclusionsOur results show that bladder instillations of combined HA+CS reduce the risk of bacteriologically confirmed recurrences compared with the current standard management of RUTIs. Total incidence rates and hazard rates were instead non-significantly different between the 2 groups after adjusting for unbalanced factors. In contrast to what happens with antibiotic prophylaxis, the effectiveness of the HA+CS reinstatement therapy improves over time. TRIAL REGISTRATION NUMBER: NCT02016118.

Indexed as

Administration, IntravesicalAdultAgedCase-Control StudiesChondroitin SulfatesDatabases, FactualDrug Therapy, CombinationEuropeFemaleHumansHyaluronic AcidMiddle AgedMultivariate AnalysisProportional Hazards ModelsQuality of LifeRecurrenceChondroitin SulfatesHyaluronic AcidAntimicrobial Resistancechondroitin sulphateHyaluronic acid

Identifiers

PMID27033958
PMCPMC4823394
OpenAlexW2317968346

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.