Side Effects of pentosan polysulfate: A Synthesis of Findings from 9 Studies

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Original Abstract of the Article

Main Research Findings

Pentosan polysulfate sodium (PPS) is a drug used to treat various conditions, including interstitial cystitis (IC). However, PPS can have several side effects, some of which can be serious. This review summarizes research on PPS side effects and discusses the risks and countermeasures.

Reasons for Side Effects

PPS side effects are believed to be related to its mechanism of action. PPS is a glycosaminoglycan-like molecule similar to heparin in structure, and it binds to the surface of vascular endothelial cells, exhibiting antithrombotic effects. This action leads to PPS suppressing vascular inflammation and reducing vascular permeability. However, PPS can also affect blood clotting factors and platelets, potentially causing bleeding and thrombocytopenia. Additionally, PPS can impact organs like the liver and kidneys, potentially causing liver dysfunction and kidney dysfunction. The severity of PPS side effects varies depending on the dosage, duration of administration, and the patient's condition.

Common Side Effects

Liver Dysfunction

Liver dysfunction has been reported as a side effect of PPS. The study 1 found that 18 out of 24 patients who received PPS exhibited elevated alanine aminotransferase (ALT) levels. Additionally, 3 out of 24 patients showed elevated aspartate aminotransferase (AST) levels.

Thrombocytopenia

PPS has the potential to cause thrombocytopenia. The study 1 observed an average platelet count reduction of 24 to 34% in patients who received PPS.

Bleeding

PPS can lead to bleeding. The study 3 observed severe subcutaneous and intramuscular hemorrhage in a cat that received PPS. Additionally, the study reported cases of retinopathy in patients who used PPS long-term.

Eye Disorders

PPS can cause eye disorders. The study reported retinopathy in patients who used PPS long-term. The study stated that PPS-induced retinopathy should be widely known among general practitioners, ophthalmologists, optometrists, and urologists.

Allergic Reactions

PPS can trigger allergic reactions. The study 5 observed eczema-like inflammation at the subcutaneous injection site in patients who received PPS.

Countermeasures for Side Effects

Liver Dysfunction

If symptoms of liver dysfunction appear, PPS administration should be discontinued, and medical attention should be sought. Steroids and other medications may be used to treat liver dysfunction.

Thrombocytopenia

If symptoms of thrombocytopenia appear, PPS administration should be discontinued, and medical attention should be sought. Blood transfusions and platelet transfusions are used to treat thrombocytopenia.

Bleeding

If symptoms of bleeding appear, PPS administration should be discontinued, and medical attention should be sought. Hemostatic agents and blood transfusions are used to treat bleeding.

Eye Disorders

If symptoms of eye disorders appear, PPS administration should be discontinued, and an ophthalmologist should be consulted. Treatment for eye disorders may include medication and laser therapy.

Allergic Reactions

If symptoms of an allergic reaction appear, PPS administration should be discontinued, and medical attention should be sought. Antihistamines and steroids are used to treat allergic reactions.

Comparison Between Studies

Similarities in Studies

Multiple studies have reported that PPS can cause side effects like liver dysfunction, thrombocytopenia, bleeding, eye disorders, and allergic reactions. The severity of these side effects varies based on the PPS dosage, duration of administration, and the patient's condition.

Differences in Studies

The incidence and severity of PPS side effects vary across studies. This is likely due to variations in the PPS formulation, dosage, duration of administration, and target patient populations used in different studies.

Precautions for Real-Life Application

PPS is used to treat conditions like interstitial cystitis. However, due to the risk of serious side effects associated with PPS, it is crucial to use it under the guidance of a physician. If you suspect PPS side effects, consult your doctor immediately.

Limitations of Current Research

Research on PPS side effects is still insufficient. Further research, especially on the long-term effects of PPS use, is required.

Future Research Directions

Further research is needed to elucidate the mechanisms behind PPS side effects and establish safe usage practices. Development of new therapeutic approaches to mitigate PPS side effects is also anticipated.

Conclusion

PPS is an effective drug for treating conditions like interstitial cystitis, but it can cause side effects like liver dysfunction, thrombocytopenia, bleeding, eye disorders, and allergic reactions. When using PPS, it is essential to follow your doctor's instructions and use it with a thorough understanding of the risk of side effects.

Literature analysis of 9 papers
Positive Content
4
Neutral Content
2
Negative Content
3
Article Type
2
0
0
2
8
1.

Tolerance and biological activity of pentosan polysulfate after intramuscular or subcutaneous administration for ten days in human volunteers.

Author: SiéP, AlbaredeJ L, RobertM, BoulouxC, LansenJ, ChigotC, CorrellS, ThouvenotJ P, BoneuB

Good tolerance
Liver enzyme elevation
Platelet reduction

Pentosan polysulfate (PPS) is a drug that can be used to treat certain medical conditions. This study investigated the tolerance and pharmacological activity of PPS in 30 healthy volunteers. PPS was well tolerated, with the most common side effects being increased transaminase levels and decreased platelet counts. The study found that PPS significantly prolonged the activated partial thromboplastin time (APTT) and induced a weak but significant circulating anti-Xa activity.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Update on maculopathy secondary to pentosan polysulfate toxicity.

Author: Abou-JaoudeMichelle, FraserClaire, MaldonadoRamiro S

PPS toxicity
Toxic maculopathy

Extended exposure to pentosan polysulfate sodium (PPS) is associated with maculopathy, with an average reported incidence of around 20% in patients with long-term exposures.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

3.

Acute and severe haemorrhage following pentosan polysulfate injection in a Cornish Rex.

Author: TongMiranda X, RomineJessica F, HardcastleMichael R

Anaemia
Cardiomyopathy
Congestive heart failure
Haemorrhage
Hypotensive shock

A 14-year-old cat died from severe subcutaneous and intermuscular hemorrhage following a subcutaneous injection of a product containing pentosan polysulfate sodium and glucosamine.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

4.

Pentosan Polysulfate Sodium Exposure and Drug-Induced Maculopathy in Commercially Insured Patients in the United States.

Author: LudwigCassie A, VailDaniel, CallawayNatalia F, PasrichaMalini V, MoshfeghiDarius M

Maculopathy risk

There is no association between pentosan polysulfate sodium (PPS) use for interstitial cystitis (IC) and subsequent diagnosis of maculopathy. This retrospective cohort study found no significant association between PPS exposure and diagnosis of any maculopathy, including drusen, nonexudative AMD, exudative AMD, toxic maculopathy, hereditary dystrophy, or an aggregate variable of any maculopathy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Delayed-type hypersensitivity skin reactions due to heparins and heparinoids. Tolerance of recombinant hirudins and of the new synthetic anticoagulant fondaparinux.

Author: KochPatrick

Safe alternative for heparin
Treatment of eczema-like plaques

Fondaparinux sodium, a synthetic pentasaccharide anticoagulant, was found to be a safe alternative to heparin in patients with eczema-like reactions to subcutaneous heparin injections.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Tolerance and biological activity of pentosan polysulfate after intramuscular or subcutaneous administration for ten days in human volunteers.

Author: SiéP, AlbaredeJ L, RobertM, BoulouxC, LansenJ, ChigotC, CorrellS, ThouvenotJ P, BoneuB

Good tolerance
Liver enzyme elevation
Platelet reduction

Pentosan polysulfate (PPS) is a drug that can be used to treat certain medical conditions. This study investigated the tolerance and pharmacological activity of PPS in 30 healthy volunteers. PPS was well tolerated, with the most common side effects being increased transaminase levels and decreased platelet counts. The study found that PPS significantly prolonged the activated partial thromboplastin time (APTT) and induced a weak but significant circulating anti-Xa activity.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Pentosan polysulfate to control hepcidin expression in vitro and in vivo.

Author: AspertiMichela, DenardoAndrea, GryzikMagdalena, CastagnaAnnalisa, GirelliDomenico, NaggiAnnamaria, ArosioPaolo, PoliMaura

Iron deficiency treatment

Hepcidin is a peptide that regulates iron levels in the body. This study examines the anti-hepcidin activity of pentosane polysulfate (PPS) in vitro and in vivo. The results show that PPS is a potent inhibitor of hepcidin expression and may be a promising compound for controlling hepcidin levels in vivo.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Intra-articular therapy in osteoarthritis.

Author: UthmanI, RaynauldJ-P, HaraouiB

Osteoarthritis treatment

This study reviews the various intra-articular therapies used in the treatment of osteoarthritis. Corticosteroids and hyaluronic acid are the most frequently used therapies, despite a lack of strong evidence supporting their efficacy in altering the progression of the disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Pentosan Polysulfate: a Novel Glycosaminoglycan-Like Molecule for Effective Treatment of Alphavirus-Induced Cartilage Destruction and Inflammatory Disease.

Author: HerreroLara J, FooSuan-Sin, ShengKuo-Ching, ChenWeiqiang, ForwoodMark R, BucalaRichard, MahalingamSuresh

Alphavirus-induced arthritis treatment
Cartilage preservation

This study investigated the therapeutic potential of pentosan polysulfate (PPS) for treating alphavirus-induced arthritis. Alphaviruses, such as Ross River virus and chikungunya virus, cause debilitating joint pain and inflammation. The study found that PPS treatment alleviated cartilage damage and reduced immune infiltrates in mouse models of alphavirus-induced arthritis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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