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Long-term use of pentosan polysulfate sodium associated with vision-threatening maculopathy

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Nieraj Jain

SAN FRANCISCO — Long-term use of pentosan polysulfate sodium is strongly associated with vision-threatening pentosan polysulfate maculopathy, a speaker said here.

“This condition masquerades as AMD and pattern dystrophy. ... This drug has been on the market for 20 years. Most affected patients are already out there, so if you have the capability to search your EMR, please do, and search for this drug to try to identify these cases,” Nieraj Jain, MD, said at Retina Subspecialty Day at the American Academy of Ophthalmology annual meeting.

Pentosan polysulfate sodium (PPS) was approved by the FDA in 1996 for the treatment of interstitial cystitis (IC), which currently affects more than 1 million U.S. adults.

Jain and colleagues conducted a retrospective cross-sectional study evaluating patients with IC at their institution over a 4-year period. The study included 219 patients with IC, 80 of whom had previous PPS exposure. The researchers identified 14 patients in the cohort with the characteristic pentosan polysulfate maculopathy, all of whom had been exposed to PPS. None of the 139 patients who had not been exposed to PPS developed pentosan polysulfate maculopathy, Jain said.

Additionally, Jain and colleagues performed a retrospective matched-cohort study on a larger scale of claims data from a U.S. insurer. The researchers found 1,604 patients who had been exposed to PPS 7 years prior had statistically significant higher odds of developing a new diagnosis of a macular disease (P = .009).

“We’re all worried about missing another case of drug toxicity in the future, but everyone should focus on the cases they’ve seen in the past,” Jain said. – by Robert Linnehan

Reference:

Jain N. Pentosan polysulfate maculopathy. Presented at: American Academy of Ophthalmology annual meeting; October 11-15, 2019; San Francisco.

Disclosure: Jain reports no relevant financial disclosures.