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Colopathy associated with pentosan polysulfate use.

Emily H Jung1, Wei Zheng2, Ryan J Weiss3,4

  • 1Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States.

Frontiers in Pharmacology
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Summary
This summary is machine-generated.

Pentosan polysulfate (PPS) use is strongly linked to inflammatory bowel disease (IBD). This study suggests a new drug-induced colopathy, with some cases requiring surgery, highlighting the need for further research.

Keywords:
colopathydextran sodium sulfateelmironinflammatory bowel diseaseinterstitial cystitisirritable bowel syndromepentosan polysulfatetoxicity

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Area of Science:

  • Gastroenterology
  • Pharmacology
  • Drug Safety

Background:

  • Pentosan polysulfate (PPS) is used for interstitial cystitis.
  • A potential link between PPS use and gastrointestinal issues, specifically inflammatory bowel disease (IBD), has been observed.

Purpose of the Study:

  • To describe a novel colopathy associated with pentosan polysulfate (PPS) use.
  • To assess the strength of the association between PPS and inflammatory bowel disease (IBD).

Main Methods:

  • A two-part investigation including a cohort study of long-term PPS users and a cross-sectional study of patients with interstitial cystitis.
  • Data collection involved medical histories, endoscopy records, histopathology, and logistic regression analysis to determine the association between PPS and IBD.

Main Results:

  • In the cohort study, 69.2% of PPS users were diagnosed with IBD, and 84.6% developed IBD symptoms.
  • Histopathologic abnormalities were found in all 10 participants with available data, and 18% required colectomy for dysplasia.
  • The cross-sectional study showed PPS use was a significant predictor of IBD diagnosis (OR 3.3, p=0.02).

Conclusions:

  • A strong association exists between pentosan polysulfate (PPS) use and the clinical diagnosis of inflammatory bowel disease (IBD).
  • Histopathologic findings suggest a novel drug-associated colopathy, with some cases progressing to dysplasia requiring colectomy.
  • Further research is warranted to establish causality between PPS use and IBD.