Purchase this article with an account.
Alexa L Li, Nieraj Jain, Yinxi Yu, Brian L VanderBeek; Association of Macular Disease with Long-term Use of Pentosan Polysulfate Sodium: Findings from a Large U.S. National Insurance Database. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5044.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
We recently described a unique pigmentary maculopathy in the setting of chronic exposure to pentosan polysulfate sodium (PPS), a treatment for interstitial cystitis. In all affected patients, these pigmentary changes were previously ascribed to a diagnosis of dry macular degeneration or pattern dystrophy. Herein, we performed a retrospective review of medical claims data from a national U.S. insurer to determine if long-term PPS usage is linked to diagnoses of varying macular disorders in a large U.S. population.
A retrospective, matched cohort study using data from a medical claims database was performed. The exposure cohort consisted of all patients prescribed PPS from 2002-2011. The index date was the date when the patient first filled a prescription for PPS, and patients were required to have at least 2 years prior to and 5 years after the index date for inclusion. Controls were matched 5:1 for age, gender, race, insurance plan eligibility start/end date and were assigned the same index date their exposed match. Exclusion occurred for being <18 years old and any dry macular degeneration (dAMD) or drusen diagnosis prior to the index date. The primary outcome was defined as a new International Classification of Disease (ICD-9/10) diagnosis code for a hereditary or secondary pigmentary retinopathy with a secondary outcome also including a new diagnosis of dAMD or drusen. Multivariate logistic regression analyses were performed controlling for demographic and systemic health variables.
1187 PPS users and 5939 controls met the eligibility criteria. At the 5-year follow-up, 5(0.4%) and 71(6.0%) PPS patients compared to 16(0.3%) and 266(4.5%) control patients progressed to the primary and secondary outcomes respectively. Multivariate analysis showed no significant association for PPS and the primary outcome (OR=1.49, 95% CI:0.54-4.11, P=0.45); however, exposure to PPS significantly increased the odds of having a secondary outcome (OR=1.39, 95% CI:1.04–1.85, P=0.03).
PPS exposure was associated with a new diagnosis of macular disease at the 5-year follow-up in a large national cohort. These results corroborate findings of the initial case series that suggested an association between PPS exposure and a novel maculopathy, although the association was noted at a lower exposure duration than in the index cases.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
This PDF is available to Subscribers Only