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American Journal of Clinical Oncology Jun 2015The optimal management of persistent hemorrhagic radiation cystitis is ill-defined. Various options are available and include oral agents (ie, sodium pentosan... (Review)
Review
The optimal management of persistent hemorrhagic radiation cystitis is ill-defined. Various options are available and include oral agents (ie, sodium pentosan polysulfate), intravenous drugs (ie, WF10), topical agents (ie, formalin), hyperbaric oxygen, and endoscopic procedures (ie, electrical cautery, argon plasma coagulation, laser coagulation). In general, it is best to manage patients conservatively and intervene only when necessary with the option least likely to exacerbate the cystitis. More aggressive measures should be employed only when more conservative approaches fail. Bladder biopsies should be avoided, unless findings suggest a bladder tumor, because they may precipitate a complication.
Topics: Administration, Intravenous; Administration, Intravesical; Administration, Oral; Anticoagulants; Chlorine; Cystitis; Formaldehyde; Hematuria; Humans; Hyaluronic Acid; Hyperbaric Oxygenation; Laser Coagulation; Oxides; Pentosan Sulfuric Polyester; Radiation Injuries; Radiation-Protective Agents; Radiotherapy; Urinary Bladder
PubMed: 24322335
DOI: 10.1097/COC.0000000000000016 -
MedRxiv : the Preprint Server For... Apr 2023We describe a novel colopathy associated with pentosan polysulfate (PPS) use and measure the strength of the drug-disease association.
INTRODUCTION
We describe a novel colopathy associated with pentosan polysulfate (PPS) use and measure the strength of the drug-disease association.
METHODS
Two-part investigation. In the cohort study of individuals with a history of prior long-term PPS use, case histories were obtained and gastrointestinal disease course was followed with review of endoscopy records and histopathology specimens. Findings were summarized with descriptive statistics. In the cross-sectional study of individuals with interstitial cystitis, drug exposure and medical histories were obtained for patients seen at a single clinical center. Strength of association between PPS use and diagnoses of inflammatory bowel disease (IBD) and/or irritable bowel syndrome (IBS) was measured with multivariate logistic regression.
RESULTS
In the cohort study of 13 participants, median PPS exposure was 2.04 kg (0.99-2.54). Eleven (84.6%) developed symptoms suggestive of IBD and/or IBS after initiation of PPS therapy. Of the 10 participants whose endoscopic and histopathologic findings we reviewed, six had abnormal-appearing colonic mucosa on endoscopy and all 10 had abnormal mucosal changes on histology. Clinical and histologic improvement was observed after PPS cessation. In the cross-sectional study of 219 subjects with interstitial cystitis, PPS use was a statistically significant predictor of both the IBD [adjusted odds ratio=3.3 (95% confidence interval, 1.2-8.8, p=0.02)] and the composite IBD+IBS [adjusted odds ratio=3.3 (95% confidence interval, 1.5-7.3, p=0.002)] outcomes.
DISCUSSION
We describe a strong association between PPS use and a clinical diagnosis of IBD and/or IBS. Histopathologic findings suggest a novel drug-associated colopathy, with some subjects requiring colectomy for dysplasia.
PubMed: 37066211
DOI: 10.1101/2023.04.03.23288071 -
Ophthalmology Jul 2019
Topics: Humans; Macular Degeneration; Pentosan Sulfuric Polyester
PubMed: 31229011
DOI: 10.1016/j.ophtha.2018.12.038 -
Ophthalmology May 2020
Topics: Humans; Macular Degeneration; Pentosan Sulfuric Polyester; United States
PubMed: 32327144
DOI: 10.1016/j.ophtha.2020.01.005 -
The Urologic Clinics of North America May 2022Interstitial cystitis/bladder pain syndrome (IC/BPS) is defined as persistent or chronic discomfort perceived to be related to the urinary bladder accompanied by urinary... (Review)
Review
Interstitial cystitis/bladder pain syndrome (IC/BPS) is defined as persistent or chronic discomfort perceived to be related to the urinary bladder accompanied by urinary urgency or frequency. Pharmacotherapies used to treat IC/BPS include oral and intravesical agents. Oral therapies include amitriptyline, hydroxyzine, cyclosporine A, and pentosan polysulfate sodium (PPS), although the recent finding of pigmented maculopathy with chronic PPS is very concerning and must be discussed with patients, many of whom will choose to either come off this medicine or not even start it. Certolizumab pegol is a pharmacologic therapy that is currently in clinical development for treatment of IC/BPS symptoms.
Topics: Cystitis, Interstitial; Female; Humans; Male; Pentosan Sulfuric Polyester; Urinary Bladder
PubMed: 35428433
DOI: 10.1016/j.ucl.2022.01.003 -
Pharmaceuticals (Basel, Switzerland) Mar 2023Pentosan polysulfate (PPS), a small semi-synthetic highly sulfated heparan sulfate (HS)-like molecule, shares many of the interactive properties of HS. The aim of this... (Review)
Review
Pentosan polysulfate (PPS), a small semi-synthetic highly sulfated heparan sulfate (HS)-like molecule, shares many of the interactive properties of HS. The aim of this review was to outline the potential of PPS as an interventional therapeutic protective agent in physiological processes affecting pathological tissues. PPS is a multifunctional molecule with diverse therapeutic actions against many disease processes. PPS has been used for decades in the treatment of interstitial cystitis and painful bowel disease, it has tissue-protective properties as a protease inhibitor in cartilage, tendon and IVD, and it has been used as a cell-directive component in bioscaffolds in tissue engineering applications. PPS regulates complement activation, coagulation, fibrinolysis and thrombocytopenia, and it promotes the synthesis of hyaluronan. Nerve growth factor production in osteocytes is inhibited by PPS, reducing bone pain in osteoarthritis and rheumatoid arthritis (OA/RA). PPS also removes fatty compounds from lipid-engorged subchondral blood vessels in OA/RA cartilage, reducing joint pain. PPS regulates cytokine and inflammatory mediator production and is also an anti-tumor agent that promotes the proliferation and differentiation of mesenchymal stem cells and the development of progenitor cell lineages that have proven to be useful in strategies designed to effect repair of the degenerate intervertebral disc (IVD) and OA cartilage. PPS stimulates proteoglycan synthesis by chondrocytes in the presence or absence of interleukin (IL)-1, and stimulates hyaluronan production by synoviocytes. PPS is thus a multifunctional tissue-protective molecule of potential therapeutic application for a diverse range of disease processes.
PubMed: 36986536
DOI: 10.3390/ph16030437 -
Ophthalmic Surgery, Lasers & Imaging... Jan 2021To provide new insights into toxic maculopathy secondary to pentosan polysulfate (PPS) utilizing multimodal testing.
BACKGROUND AND OBJECTIVE
To provide new insights into toxic maculopathy secondary to pentosan polysulfate (PPS) utilizing multimodal testing.
PATIENTS AND METHODS
Retrospective case-series of four patients from two academic centers evaluated with multimodal imaging, electrophysiology, dark adaptometry (DA), and genetic testing.
RESULTS
Median age was 58 years, exposure to PPS was 18.5 years, and cumulative dose of was 2,025 grams. Seven of eight eyes had visual acuity of 20/40 or better. Optical coherence tomography (OCT) angiography demonstrated increased choriocapillaris flow voids (54.25%) in cases compared to controls (13.2%). Two subjects had abnormal foveal avascular zone configurations. Two subjects demonstrated collapse of the retinal pigment epithelium nodular excrescences and progressive retinal thinning over 4 to 5 years on OCT. Electrophysiology was normal (3/3 patients), but DA was delayed (2/2 patients).
CONCLUSIONS
The authors describe novel findings of PPS maculopathy, including flow voids in the choriocapillaris. Progressive retinal thinning may suggest a secondary retinal effect. These findings may improve understanding of the pathophysiology. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:13-22.].
Topics: Humans; Macular Degeneration; Middle Aged; Pentosan Sulfuric Polyester; Retinal Diseases; Retinal Pigment Epithelium; Retrospective Studies
PubMed: 33471910
DOI: 10.3928/23258160-20201223-04 -
JAMA Ophthalmology Mar 2022
Topics: Humans; Pentosan Sulfuric Polyester; Retinal Diseases
PubMed: 35084438
DOI: 10.1001/jamaophthalmol.2021.5972 -
Asia-Pacific Journal of Ophthalmology...This study will provide a thorough review of systemic (and select intravitreal) medications, along with illicit drugs that are capable of causing various patterns of...
This study will provide a thorough review of systemic (and select intravitreal) medications, along with illicit drugs that are capable of causing various patterns of retinal toxicity. The diagnosis is established by taking a thorough medication and drug history, and then by pattern recognition of the clinical retinal changes and multimodal imaging features. Examples of all of these types of toxicity will be thoroughly reviewed, including agents that cause retinal pigment epithelial disruption (hydroxychloroquine, thioridazine, pentosan polysulfate sodium, dideoxyinosine), retinal vascular occlusion (quinine, oral contraceptives), cystoid macular edema/retinal edema (nicotinic acid, sulfa-containing medications, taxels, glitazones), crystalline deposition (tamoxifen, canthaxanthin, methoxyflurane), uveitis, miscellaneous, and subjective visual symptoms (digoxin, sildenafil). The impact of newer chemotherapeutics and immunotherapeutics (tyrosine kinase inhibitor, mitogen-activated protein kinase kinase, checkpoint, anaplastic lymphoma kinase, extracellular signal-regulated kinase inhibitors, and others), will also be thoroughly reviewed. The mechanism of action will be explored in detail when known. When applicable, preventive measures will be discussed, and treatment will be reviewed. Illicit drugs (cannabinoids, cocaine, heroin, methamphetamine, alkyl nitrite), will also be reviewed in terms of the potential impact on retinal function.
Topics: Humans; Retina; Retinal Diseases; Macular Edema; Uveitis; Illicit Drugs; Retinal Vein Occlusion; Intravitreal Injections; Tomography, Optical Coherence
PubMed: 36971705
DOI: 10.1097/APO.0000000000000605 -
CMAJ : Canadian Medical Association... May 2021
Topics: Anticoagulants; Cystitis, Interstitial; Humans; Macular Degeneration; Pentosan Sulfuric Polyester; Time Factors; Vision Disorders
PubMed: 33941523
DOI: 10.1503/cmaj.201900