Risk factors for pentosan polysulfate maculopathy

Area of Science:

• Ophthalmology
• Pharmacology
• Toxicology

Background:

• Pentosan polysulfate (PPS) is used for interstitial cystitis and osteoarthritis.
• Ocular toxicity, specifically maculopathy, has been associated with PPS use.
• Identifying risk factors is crucial for patient safety and informed clinical practice.

Purpose of the Study:

• To determine the risk factors associated with the development of pentosan polysulfate (PPS) maculopathy.
• To evaluate the dose-dependency and other contributing factors to PPS-induced ocular toxicity.

Main Methods:

• A cross-sectional study was conducted involving 187 individuals exposed to PPS at Emory Eye Center.
• Data were collected via questionnaires and fundus imaging.
• Multivariate and subgroup analyses identified risk factors for maculopathy.

Main Results:

• Risk of PPS maculopathy is dose-dependent, with the highest quartile of exposure showing significantly increased risk (OR 39.8).
• Additional risk factors include cumulative dose per body weight, female sex, older age, and history of inflammatory bowel disease or irritable bowel syndrome.
• Prevalence of toxicity in PPS users at Emory ranged from 3.8% to 24.5%.

Conclusions:

• Cumulative PPS exposure is the primary driver of maculopathy risk.
• Age, gender, and body weight may also play a role in PPS toxicity.
• Findings support the need for revised dosing guidelines and screening protocols for PPS users globally.