Non-muscle (superficial) invasive bladder cancer accounted for about 6% of all cancers in Canada in 2008. To treat this condition, systemic drug delivery to the bladder is generally ineffective as the bladder’s wall prevents therapeutic substances from diffusing through. Intravesical therapy delivers drugs through a catheter directly into the bladder and is therefore more effective, but still faces limitations resulting in the need for a high frequency of instillations among other issues. Furthermore, superficial bladder cancer has a high recurrence rate. In 2006, the condition was reported to cost $65,158 per patient on average in the U.S., largely as a result of complications and surveillance of recurrence.

In the last two decades, the use of electromotive force has emerged as an option to increase diffusion of drugs into the bladder. Electromotive drug administration (EDMA) has shown some potential in treatment of various bladder conditions such as detrusor overactivity and bladder pain syndrome, conditions that face similar drug-delivery challenges to bladder cancer. However Canadian guidelines on treatment for bladder cancer issued in 2010 did not find enough evidence to provide recommendations on this therapy. The aim of this review is to examine the evidence regarding the efficacy, safety, and cost-effectiveness of using EDMA to treat superficial bladder cancer.

Contents

• CONTEXT AND POLICY ISSUES
• RESEARCH QUESTIONS
• KEY FINDINGS
• METHODS
  • Literature Search Strategy
  • Selection Criteria and Methods
  • Exclusion Criteria
  • Critical Appraisal of Individual Studies
• SUMMARY OF EVIDENCE
  • Quantity of Research Available
  • Summary of Study Characteristics
  • Summary of Critical Appraisal
  • Summary of Findings
  • Limitations
• CONCLUSIONS AND IMPLICATIONS FOR DECISION OR POLICY MAKING
• REFERENCES
• APPENDIX 1 Selection of Included Studies
• APPENDIX 2 Other References of Potential Interest (Did not meet inclusion criteria)

Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.