Pentosan Polysulfate Use Linked to Increased Risk of Maculopathy, finds research
Researchers showed that antibiotic therapy with pentosan polysulfate (PPS) is associated with a significant risk of maculopathy, a leading cause of severe impairment of vision in any stage of the disease. The results derive from a nationwide, population-based Asian study of more than 300,000 individuals diagnosed with cystitis. The study was conducted by Kim and colleagues and was published in the journal of Ophthalmology.
This was a retrospective cohort study with 103,553 in the PPS user group and 205,792 in the non-user group, all who were newly diagnosed with cystitis between 2009 and 2020. This sample size was adequate to give a substantial basis for analyzing the potential risks associated with PPS. The two groups were followed over time to establish whether the incidence of maculopathy occurred following the use of PPS.
To establish the association between the use of PPS and maculopathy, researchers applied a time-dependent Cox proportional hazard model. Two sensitivity analyses were also conducted for those with a cumulative dose above 9 grams of PPS.
• The use of PPS was significantly associated with an increased risk of maculopathy. In the univariate analysis, the HR for maculopathy was 1.7 (95% CI, 1.66–1.75), which means that patients using PPS have 70% higher risk of maculopathy compared to a patient who is not using it.
• Adjusting for confounding factors, multivariate analysis remained significant with a hazard ratio of 1.34 (95% CI, 1.31–1.38), indicating 34% increased risk among the PPS users.
• The average cumulative dose of PPS for the cohort was 37.2 ± 76.7 grams. Sensitivity analyses further confirmed the basic results: the risks of maculopathy remained increased with prolonged exposure or higher cumulative doses.
This multicenter national cohort study has established that there is a relationship between the use of pentosan polysulfate and the incidence of maculopathy in patients with cystitis. Physicians must further weigh benefits of PPS against the risk of maculopathy developing and to utilize alternative treatments when appropriate. Further research needs to occur to provide more concrete guidelines about the use of PPS in management of cystitis and long-term implications for eye health.
Reference:
Kim, M. S., Choi, Y. J., Ji, E., Song, S. H., Joo, K., Park, S. J., & Woo, S. J. (2024). Association between pentosan polysulfate and subsequent maculopathy: Insights from a nationwide population-based study in Korea. Ophthalmology.https://doi.org/10.1016/j.ophtha.2024.07.027
