SUFU 2021: Influence of Ocular Complication Risk in Pentosan Polysulfate Use for Interstitial Cystitis

( Pentosan polysulfate sodium (PPS) is commonly prescribed for interstitial cystitis although it has been implicated in the development of maculopathy in patients with lifetime cumulative doses of greater than 500g. This study evaluated patient perceptions of PPS benefit and risk of maculopathy.

Patients studied included those who were previously or currently treated with PPS and who also underwent screening for PPS-associated maculopathy. The cumulative lifetime dose was calculated based on reported years of usage and maximum daily dose. A total of 64 patients were included in the analysis, 27 taking PPS, and 37 were no longer taking PPS. Ten patients screened positive for maculopathy (2 taking, 8 not taking), and three were indeterminate (all not taking). The total years on PPS ranged from 0.25 to 35 years (IQR 15-2.5) and the cumulative dose ranged from 18.25 to 6570 grams. The mean cumulative dose was similar in both the taking versus not taking groups. Patients with confirmed ocular complications had higher mean cumulative doses and were more likely to no longer be taking PPS. The perception of maculopathy risk was similar in both groups (p=0.22). Patients in the highest quartile of cumulative dose were more likely to report concern for ocular complications. The authors recommend that providers should counsel patients on the risk of ocular complications in high dose PPS use, and consider alternative therapies.

Presented by: Daniela Kaefer, Victoria Lee, Breeā€™ava Limbrick, Ja-Hong Kim UCLA, Dept. of Urology, UCLA David Geffen School of Medicine

Written by: Diane K. Newman, DNP, CRNP, FAAN, BCB-PMD, Nurse Practioner and Co-Director, Penn Center for Continence and Pelvic Health Adjunct Professor of Urology in Surgery during the 2021 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Winter Meeting.