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Context, anatomy, and key evidence

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glycosaminoglycan

Pentosan Polysulfate

Published evidence · coverage incomplete

Anatomy in the research

Anatomy evidence is still being assembled.

These are anatomical mentions in cited research—not established treatment targets or proof of benefit in people.

This publication has no anatomy passages that meet our source-linking checks yet. Read the available findings ↓

General anatomy view only. No peptide-specific structures are highlighted.

At a glance

What is it—and why does it matter?

An introduction is not yet available. The findings below address specific research questions, not a complete account of this peptide.

This published profile is a reference in progress. Findings retain their source context; missing topics are marked below.

What is it?

A molecule, not a product name.

Identity

Pentosan polysulfate sodium is described as a semi-synthetic, heparin-like macromolecular carbohydrate derivative with chemical and structural similarity to glycosaminoglycans.

Regulatory record

1 cited source · 1 regulatory record

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Pentosan polysulfate sodium is a semi-synthetically produced heparin-like macromolecular carbohydrate derivative, which chemically and structurally resembles glycosaminoglycans.

    ELMIRON®100 MG(PENTOSAN POLYSULFATE SODIUM)CAPSULES · DESCRIPTION

    dailymed:f0ba651e-3d8a-11df-8fbe-119855d89593:d135d76fd516:d135d76fd516

Identity

The abstract explicitly equates pentosan polysulfate sodium (PPS) with the name Elmiron.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    While bladder fulguration and pentosan polysulfate sodium (PPS, Elmiron) are established treatments

    Impact of Elmiron adjunct therapy on outcomes of fulguration in chronic interstitial cystitis in women. · Abstract

    pubmed:41578241:f88f7a4b6877:f88f7a4b6877

How does it work?

Target, response, and disposition.

Mechanism

PPS is reported to bind or otherwise interact with PF4, a protein implicated in heparin-associated thrombocytopenia mechanisms.

Molecular / pharmacology evidence

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    and also interacts with platelet factor 4 (PF4)

    Pentosan Polysulfate and Heparin Exhibit Comparable Interactions with Platelet Factor 4, Suggesting a Potential Risk of Thrombocytopenia. · Abstract

    pubmed:41658182:80815a5493e3:80815a5493e3

Mechanism

The study operationalized visual acuity by applying conversion methods (e.g., Snellen to logMAR and letter scores) to identify best documented VA.

Human research · design must be checked

1 cited source · 1 linked study ID

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Best documented VA was evaluated using VA conversion methods (e.g. from Snellen chart VA to logMAR units and letters).

    Retrospective study of visual acuity changes in patients with interstitial cystitis receiving pentosan polysulfate sodium. · METHODS

    pubmed:41989996:3ab7e370d278:3ab7e370d278

Mechanism

The study methodology involved longitudinal follow-up of two patients using repeated ophthalmic examinations and multimodal fundus imaging.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Two patients followed with serial ophthalmic examination and multimodal fundus imaging.

    Late Development of Clinically Apparent Pentosan Polysulfate Maculopathy after Drug Cessation. · METHODS

    pubmed:41920598:71d3e1411729:71d3e1411729

Mechanism

The work assesses FLIO imaging signals in PPS maculopathy and compares/correlates them with other retinal imaging modalities (FAF and OCT).

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    This study evaluated fluorescence lifetime imaging ophthalmoscopy (FLIO) in PPS maculopathy patients and correlated findings with fundus autofluorescence (FAF) and optical coherence tomography (OCT).

    Characterization of Pentosan Polysulfate Sodium Maculopathy With Fluorescence Lifetime Imaging. · PURPOSE

    pubmed:42138584:3eecda95bfb0:3eecda95bfb0

Mechanism

The design is prospective and enrolls individuals diagnosed with PPS maculopathy at a single institution (University of California, San Diego).

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    This prospective study included patients with confirmed PPS maculopathy at the University of California, San Diego.

    Characterization of Pentosan Polysulfate Sodium Maculopathy With Fluorescence Lifetime Imaging. · METHODS

    pubmed:42138584:3eecda95bfb0:3eecda95bfb0

Mechanism

The label states that the mechanism of action in interstitial cystitis has not been established.

Regulatory record

1 cited source · 1 regulatory record

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    The mechanism of action of pentosan polysulfate sodium in interstitial cystitis is not known.

    ELMIRON®100 MG(PENTOSAN POLYSULFATE SODIUM)CAPSULES · General

    dailymed:f0ba651e-3d8a-11df-8fbe-119855d89593:d135d76fd516:d135d76fd516

Mechanism

PPS forms complexes with PF4.

Molecular / pharmacology evidence

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    despite PPS forming complexes with PF4

    Pentosan Polysulfate and Heparin Exhibit Comparable Interactions with Platelet Factor 4, Suggesting a Potential Risk of Thrombocytopenia. · Abstract

    pubmed:41658182:80815a5493e3:80815a5493e3

Mechanism

The abstract’s objective is to evaluate adjunctive Elmiron as an add-on to fulguration to see if it enhances measured therapeutic outcomes in a specific patient group.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    To evaluate whether adjunctive Elmiron therapy enhances the therapeutic outcomes of fulguration in female patients with Hunner-type IC.

    Impact of Elmiron adjunct therapy on outcomes of fulguration in chronic interstitial cystitis in women. · Abstract

    pubmed:41578241:f88f7a4b6877:f88f7a4b6877

Mechanism

The research design was retrospective and observational (non-interventional), leveraging registry and claims/health databases over 1 January 2015 to 1 March 2021.

Human research · design must be checked

1 cited source · 1 linked study ID

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    This retrospective, non-interventional cohort study (NCT05179460) using data from the American Academy of Ophthalmology IRIS (Intelligent Research in Sight) Registry and Komodo Health database from 1 January 2015 to 1 March 2021 assessed VA changes in two matched cohorts of IC patients: "PPS-Exposed Cohort," and "Non-PPS-exposed Cohort."

    Retrospective study of visual acuity changes in patients with interstitial cystitis receiving pentosan polysulfate sodium. · METHODS

    pubmed:41989996:3ab7e370d278:3ab7e370d278

Mechanism

Outcome ascertainment used masked expert grading of multimodal retinal imaging with predefined criteria and adjudication, reducing observer bias in this retrospective review.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Two masked retina specialists evaluated available multimodal imaging for pigmentary maculopathy using the established criteria, with any disagreements adjudicated by a third reviewer.

    Pigmentary Maculopathy in Patients with Interstitial Cystitis: Association with Pentosan Polysulfate and Other Therapies. · METHODS

    pubmed:41049115:a984012a8824:a984012a8824

Mechanism

Atomic force microscopy is reported to corroborate the molecular-weight-dependent increase in PPS–PF4 interaction strength.

Molecular / pharmacology evidence

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    and the same trend was confirmed by atomic force microscopy.

    Pentosan Polysulfate and Heparin Exhibit Comparable Interactions with Platelet Factor 4, Suggesting a Potential Risk of Thrombocytopenia. · Abstract

    pubmed:41658182:80815a5493e3:80815a5493e3

Pharmacokinetics

Using urinary radioactivity as the basis, the mean estimated systemic absorption of an oral radiolabeled dose was approximately 6%.

Regulatory record

1 cited source · 1 regulatory record

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Based on urinary excretion of radioactivity, a mean of approximately 6% of a radiolabeled oral dose of pentosan polysulfate sodium is absorbed and reaches the systemic circulation.

    ELMIRON®100 MG(PENTOSAN POLYSULFATE SODIUM)CAPSULES · Absorption

    dailymed:f0ba651e-3d8a-11df-8fbe-119855d89593:d135d76fd516:d135d76fd516

Pharmacokinetics

In healthy subjects given radiolabeled oral solution doses, fecal excretion accounted for a large fraction of dose as unchanged drug, differing between 300 mg and 450 mg groups.

Regulatory record

1 cited source · 1 regulatory record

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    A large proportion of the orally administered dose of pentosan polysulfate sodium (mean 84% in the 300 mg group and 58% in the 450 mg group) is excreted in feces as unchanged drug.

    ELMIRON®100 MG(PENTOSAN POLYSULFATE SODIUM)CAPSULES · Excretion

    dailymed:f0ba651e-3d8a-11df-8fbe-119855d89593:d135d76fd516:d135d76fd516

Pharmacokinetics

A radiolabeled clinical pharmacology study in fasted healthy female volunteers reported a median time of 2 hours to maximal plasma radioactivity after single oral 300 or 450 mg dosing.

Regulatory record

1 cited source · 1 regulatory record

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    In a clinical pharmacology study in which healthy female volunteers received a single oral 300 or 450 mg dose of pentosan polysulfate sodium containing radiolabeled drug as a solution under fasted conditions, maximal levels of plasma radioactivity were seen approximately at a median of 2 hours (range 0.6-120 hours) after dosing.

    ELMIRON®100 MG(PENTOSAN POLYSULFATE SODIUM)CAPSULES · Absorption

    dailymed:f0ba651e-3d8a-11df-8fbe-119855d89593:d135d76fd516:d135d76fd516

What has been studied?

What the evidence says.

Comparative evidence

In an age-stratified comparison, voiding volume changed in a less favorable direction in the younger-than-65 group than in the older-than-65 group, with statistical significance.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Compared to patients older than 65 years, those younger than 65 years showed significantly better improvements in the IPSS (-0.492 vs. -0.184,P= 0.018) but worse in voiding volume (-2.481 vs. 5.032,P= 0.006).

    Efficacy and safety of pentosan polysulfate therapy in patients with interstitial cystitis for relief of lower urinary tract symptoms: 15-year single center experience. · RESULTS

    pubmed:41472923:c45e9adab638:c45e9adab638

Comparative evidence

The control/comparator group in this analysis consisted of patients who did not receive adjunctive Elmiron following fulguration.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    while Group 2 (n = 48) did not.

    Impact of Elmiron adjunct therapy on outcomes of fulguration in chronic interstitial cystitis in women. · Abstract

    pubmed:41578241:f88f7a4b6877:f88f7a4b6877

Comparative evidence

An age-stratified comparison reports a statistically greater IPSS improvement in the younger-than-65 group compared with the older-than-65 group.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Compared to patients older than 65 years, those younger than 65 years showed significantly better improvements in the IPSS (-0.492 vs. -0.184,P= 0.018) but worse in voiding volume (-2.481 vs. 5.032,P= 0.006).

    Efficacy and safety of pentosan polysulfate therapy in patients with interstitial cystitis for relief of lower urinary tract symptoms: 15-year single center experience. · RESULTS

    pubmed:41472923:c45e9adab638:c45e9adab638

Comparative evidence

The analysis uses matched controls (age, sex, lens status) to contextualize FLIO measurements in PPS maculopathy.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    FLIO data were compared to age-, sex- and lens-status-matched controls.

    Characterization of Pentosan Polysulfate Sodium Maculopathy With Fluorescence Lifetime Imaging. · METHODS

    pubmed:42138584:3eecda95bfb0:3eecda95bfb0

Study findings

In this retrospective PPS maculopathy series, over follow-up, stage progression occurred in 37.5% of eyes.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Overall, 37.5% of eyes showed progression of maculopathy stage, and cRORA was present in 75% of eyes at last follow-up.

    Spectrum of Colopathy and Severe Polyposis Associated With Pentosan Polysulfate Sodium Maculopathy: A Retrospective Case Series. · RESULTS

    pubmed:41785987:1bfa6415ea64:1bfa6415ea64

Study findings

The authors conclude PPS improved clinical pain, joint function, and cartilage volume compared with placebo, and cite biomarker changes at weeks 8 and 26 as supporting evidence.

Animal / laboratory evidence

1 cited source · Study independence not established

Animal or laboratory findings do not establish benefit or safety in people.

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    PPS-treated dogs experienced improvements in pain, joint function, and cartilage volume compared to placebo, supported by changes in biomarkers at weeks 8 and 26.

    Effects of pentosan polysulfate sodium on joint structure and function out to six months in naturally-occurring canine osteoarthritis. · CONCLUSIONS

    pubmed:41666203:c8506754641f:c8506754641f

Study findings

Uroflowmetry voiding volume was not significantly different over time following PPS treatment.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    For UFM parameters, postvoid residual decreased significantly over time (-1.052,P= 0.029), while maximum flow rate (0.093,P= 0.334) and voiding volume (0.751,P= 0.586) showed no significant differences.

    Efficacy and safety of pentosan polysulfate therapy in patients with interstitial cystitis for relief of lower urinary tract symptoms: 15-year single center experience. · RESULTS

    pubmed:41472923:c45e9adab638:c45e9adab638

Study findings

In this case series, PPS maculopathy stage distribution at last follow-up shifted toward higher stages compared with presentation.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    At final follow-up, 25% of eyes were stage 1, 50% stage 2, and 25% stage 3.

    Spectrum of Colopathy and Severe Polyposis Associated With Pentosan Polysulfate Sodium Maculopathy: A Retrospective Case Series. · RESULTS

    pubmed:41785987:1bfa6415ea64:1bfa6415ea64

Study findings

This retrospective cohort found that PPS-exposed patients were more likely to have amitriptyline exposure, indicating confounding by co-therapies may be relevant when assessing maculopathy associations.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Patients with PPS exposure had increased odds of exposure to hydroxyzine (odds ratio [OR]: 4.76,P< 0.0001), amitriptyline (OR: 2.62,P< 0.0002)

    Pigmentary Maculopathy in Patients with Interstitial Cystitis: Association with Pentosan Polysulfate and Other Therapies. · RESULTS

    pubmed:41049115:a984012a8824:a984012a8824

Study findings

Functional outcome: gait symmetry normalized through week 26 in the PPS-treated group, interpreted in the text as reduced lameness and improved function.

Animal / laboratory evidence

1 cited source · Study independence not established

Animal or laboratory findings do not establish benefit or safety in people.

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    The PPS-treated group experienced normalization of gait symmetry up to week 26, indicating a reduction in lameness and an improvement in overall function.

    Effects of pentosan polysulfate sodium on joint structure and function out to six months in naturally-occurring canine osteoarthritis. · RESULTS

    pubmed:41666203:c8506754641f:c8506754641f

Study findings

Within the <800 g subgroup, maculopathy presence was associated with higher cumulative dose normalized to body weight compared with no maculopathy.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    In low-exposure cases (<800 g), those with maculopathy were older (67.1 vs 56.9 years, P = .01), had longer PPS exposure (11 vs 7.9 years, P = .03), a greater dose per body weight (9.7 vs 5.1 g/kg, P < .001)

    Risk factors for pentosan polysulfate maculopathy. · RESULTS

    pubmed:41962908:840ed7d52888:840ed7d52888

Study findings

Adjusted analysis indicated sustained reductions in HCPI (a chronic pain index) at 26 weeks in PPS-treated dogs compared with placebo.

Animal / laboratory evidence

1 cited source · Study independence not established

Animal or laboratory findings do not establish benefit or safety in people.

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    PPS-treated dogs experienced sustained HCPI reductions compared to placebo at 26 weeks after adjusting for differences in baseline pain.

    Effects of pentosan polysulfate sodium on joint structure and function out to six months in naturally-occurring canine osteoarthritis. · RESULTS

    pubmed:41666203:c8506754641f:c8506754641f

Study findings

Within this interstitial cystitis cohort, PPS exposure status was associated with differential co-medication use; hydroxyzine exposure was more common among those exposed to PPS by odds ratio.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Patients with PPS exposure had increased odds of exposure to hydroxyzine (odds ratio [OR]: 4.76,P< 0.0001)

    Pigmentary Maculopathy in Patients with Interstitial Cystitis: Association with Pentosan Polysulfate and Other Therapies. · RESULTS

    pubmed:41049115:a984012a8824:a984012a8824

Study findings

The abstract reports a statistically significant between-group difference favoring Elmiron for reduction of the Interstitial Cystitis Problem Index (ICPI) at 6 months compared with no Elmiron.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    in ICPI scores at both 6 months (p = 0.040)

    Impact of Elmiron adjunct therapy on outcomes of fulguration in chronic interstitial cystitis in women. · Abstract

    pubmed:41578241:f88f7a4b6877:f88f7a4b6877

Study findings

In PPS maculopathy, the abstract highlights functional visual symptoms including poor dark adaptation and worsening central vision over time.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Affected individuals often experience impaired dark adaptation and progressive central vision loss.

    Pentosan polysulfate maculopathy: clinical considerations, pathobiology, and causality. · Abstract

    pubmed:40962246:90cf14d08772:90cf14d08772

Study findings

In the reported results, subcutaneous iPPS was linked to changes in synovial fluid biomarker levels measured at Day 56.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Subcutaneous iPPS treatment was associated with altered synovial fluid biomarkers at Day 56.

    Effects of pentosan polysulfate sodium on synovial fluid biomarkers in moderate to severe knee osteoarthritis: an exploratory, phase 2, randomized, double-blind, placebo-controlled trial. · RESULTS

    pubmed:41588475:ec022a0712b2:ec022a0712b2

Study findings

Within the <800 g cumulative exposure subgroup, maculopathy status was associated with higher age compared with no maculopathy.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    In low-exposure cases (<800 g), those with maculopathy were older (67.1 vs 56.9 years, P = .01)

    Risk factors for pentosan polysulfate maculopathy. · RESULTS

    pubmed:41962908:840ed7d52888:840ed7d52888

Study findings

In this retrospective case series of PPS maculopathy, GI evaluation by colonoscopy frequently identified severe adenomatous polyposis (6/8 patients, 75%).

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Colonoscopy revealed severe adenomatous polyposis in 6 of the 8 patients (75%), with 3 requiring partial or total colectomy and 2 undergoing endoscopic resection.

    Spectrum of Colopathy and Severe Polyposis Associated With Pentosan Polysulfate Sodium Maculopathy: A Retrospective Case Series. · RESULTS

    pubmed:41785987:1bfa6415ea64:1bfa6415ea64

Study findings

Imaging outcome: MRI-assessed total cartilage volume increased at weeks 8 and 26 versus baseline in the PPS arm relative to placebo.

Animal / laboratory evidence

1 cited source · Study independence not established

Animal or laboratory findings do not establish benefit or safety in people.

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Total cartilage volume increased at weeks 8 and 26 from baseline in the PPS-treated group compared to placebo

    Effects of pentosan polysulfate sodium on joint structure and function out to six months in naturally-occurring canine osteoarthritis. · RESULTS

    pubmed:41666203:c8506754641f:c8506754641f

Study findings

Baseline imbalance: the PPS arm started with higher HCPI-measured pain than the placebo arm (15.14 vs 8.83).

Animal / laboratory evidence

1 cited source · Study independence not established

Animal or laboratory findings do not establish benefit or safety in people.

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    At baseline, the PPS-treated group had higher pain with Helsinki Chronic Pain Index (HCPI) scores of 15.14 compared to 8.83 in placebo.

    Effects of pentosan polysulfate sodium on joint structure and function out to six months in naturally-occurring canine osteoarthritis. · RESULTS

    pubmed:41666203:c8506754641f:c8506754641f

Study findings

In this retrospective analysis, postoperative adjunctive Elmiron (given for 6 months) did not produce statistically significant differences between groups on the Visual Analogue Scale (VAS) at any measured time point compared with no Elmiron.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    No statistically significant differences were observed between groups in VAS scores at any time point.

    Impact of Elmiron adjunct therapy on outcomes of fulguration in chronic interstitial cystitis in women. · Abstract

    pubmed:41578241:f88f7a4b6877:f88f7a4b6877

Study findings

Within the <800 g subgroup, maculopathy presence was associated with longer duration of PPS exposure compared with those without maculopathy.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    In low-exposure cases (<800 g), those with maculopathy were older (67.1 vs 56.9 years, P = .01), had longer PPS exposure (11 vs 7.9 years, P = .03)

    Risk factors for pentosan polysulfate maculopathy. · RESULTS

    pubmed:41962908:840ed7d52888:840ed7d52888

Study findings

Uroflowmetry results indicate a statistically significant reduction in postvoid residual over time following PPS treatment.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    For UFM parameters, postvoid residual decreased significantly over time (-1.052,P= 0.029), while maximum flow rate (0.093,P= 0.334) and voiding volume (0.751,P= 0.586) showed no significant differences.

    Efficacy and safety of pentosan polysulfate therapy in patients with interstitial cystitis for relief of lower urinary tract symptoms: 15-year single center experience. · RESULTS

    pubmed:41472923:c45e9adab638:c45e9adab638

Study findings

A matched cohort analysis comparing exposed vs non-exposed interstitial cystitis patients reported no evidence that pentosan polysulfate sodium exposure affected visual acuity progression during 36 months of follow-up.

Human research · design must be checked

1 cited source · 1 linked study ID

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Over the 36 months of follow-up period, this matched cohort analysis found no supporting evidence that PPS exposure in IC patients impacted the progression of VA compared to those patients not exposed to PPS.

    Retrospective study of visual acuity changes in patients with interstitial cystitis receiving pentosan polysulfate sodium. · CONCLUSIONS

    pubmed:41989996:3ab7e370d278:3ab7e370d278

Study findings

Relative to placebo at Day 56, iPPS was associated with a negative adjusted change-from-baseline least squares mean difference for COMP, reported as a percent difference with interval (-62.60, 15.40).

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    In iPPS-treated versus placebo-treated participants at Day 56, the adjusted change from baseline least squares mean difference of cartilage metabolism markers COMP and ARGS decreased -23.60% (-62.60, 15.40) and -56.60% (-106.59, -6.62; p = 0.028), respectively.

    Effects of pentosan polysulfate sodium on synovial fluid biomarkers in moderate to severe knee osteoarthritis: an exploratory, phase 2, randomized, double-blind, placebo-controlled trial. · RESULTS

    pubmed:41588475:ec022a0712b2:ec022a0712b2

Study findings

The authors conclude FLIO has potential clinical utility as a non-invasive modality for diagnosis and longitudinal monitoring in PPS maculopathy.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    FLIO is a promising non-invasive tool for diagnosing and monitoring PPS maculopathy.

    Characterization of Pentosan Polysulfate Sodium Maculopathy With Fluorescence Lifetime Imaging. · CONCLUSION

    pubmed:42138584:3eecda95bfb0:3eecda95bfb0

Study findings

In the reported PPS maculopathy case series, management of severe adenomatous polyposis included colectomy (3 patients) and endoscopic resection (2 patients).

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Colonoscopy revealed severe adenomatous polyposis in 6 of the 8 patients (75%), with 3 requiring partial or total colectomy and 2 undergoing endoscopic resection.

    Spectrum of Colopathy and Severe Polyposis Associated With Pentosan Polysulfate Sodium Maculopathy: A Retrospective Case Series. · RESULTS

    pubmed:41785987:1bfa6415ea64:1bfa6415ea64

Study findings

Within the <800 g subgroup, maculopathy presence was associated with lower body weight compared with those without maculopathy.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    In low-exposure cases (<800 g), those with maculopathy were older (67.1 vs 56.9 years, P = .01), had longer PPS exposure (11 vs 7.9 years, P = .03), a greater dose per body weight (9.7 vs 5.1 g/kg, P < .001), and lower body weight (63.9 vs 74.4 kg, P = .03).

    Risk factors for pentosan polysulfate maculopathy. · RESULTS

    pubmed:41962908:840ed7d52888:840ed7d52888

Study findings

In this retrospective PPS maculopathy case series, the median interval from PPS initiation to GI diagnosis was 10 years.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    The median latency to GI diagnosis was 10 years after PPS initiation.

    Spectrum of Colopathy and Severe Polyposis Associated With Pentosan Polysulfate Sodium Maculopathy: A Retrospective Case Series. · RESULTS

    pubmed:41785987:1bfa6415ea64:1bfa6415ea64

Study findings

In this retrospective study subset with multimodal retinal imaging, all identified pigmentary maculopathy cases were in the PPS-exposed group, suggesting an exposure-associated pattern in the sampled clinic population.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Of the 122 patients with retinal imaging (71 with PPS exposure, 51 without), 8 patients (16 eyes) were graded to have pigmentary maculopathy and all 8 patients had PPS exposure.

    Pigmentary Maculopathy in Patients with Interstitial Cystitis: Association with Pentosan Polysulfate and Other Therapies. · RESULTS

    pubmed:41049115:a984012a8824:a984012a8824

Study findings

Within this retrospective PPS maculopathy cohort, ulcerative colitis occurred in one patient.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    One patient developed ulcerative colitis, and 2 additional patients were diagnosed with Crohn's disease or microscopic colitis.

    Spectrum of Colopathy and Severe Polyposis Associated With Pentosan Polysulfate Sodium Maculopathy: A Retrospective Case Series. · RESULTS

    pubmed:41785987:1bfa6415ea64:1bfa6415ea64

Study findings

The results report a statistically significant longitudinal improvement in QoL after oral PPS, with a plateau by 3 months.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    There were significant gains in total IPSS (-0.335,P< 0.001) and QoL (-0.061,P< 0.001) over time, achieving stable phase within 3 months from the initiation of PPS treatment.

    Efficacy and safety of pentosan polysulfate therapy in patients with interstitial cystitis for relief of lower urinary tract symptoms: 15-year single center experience. · RESULTS

    pubmed:41472923:c45e9adab638:c45e9adab638

Study findings

Within PPS maculopathy, fluorescence lifetime measures on FLIO are statistically associated with severity grading.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Lifetimes also varied significantly with maculopathy severity (p<0.05).

    Characterization of Pentosan Polysulfate Sodium Maculopathy With Fluorescence Lifetime Imaging. · RESULTS

    pubmed:42138584:3eecda95bfb0:3eecda95bfb0

Study findings

The abstract reports a statistically significant greater reduction in Interstitial Cystitis Problem Index (ICPI) at 12 months in the Elmiron group compared with no Elmiron.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    and 12 months (p < 0.001)

    Impact of Elmiron adjunct therapy on outcomes of fulguration in chronic interstitial cystitis in women. · Abstract

    pubmed:41578241:f88f7a4b6877:f88f7a4b6877

Study findings

This retrospective analysis using linear mixed models reports a statistically significant longitudinal decrease (improvement) in total IPSS after oral PPS, with a plateau by 3 months.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    There were significant gains in total IPSS (-0.335,P< 0.001) and QoL (-0.061,P< 0.001) over time, achieving stable phase within 3 months from the initiation of PPS treatment.

    Efficacy and safety of pentosan polysulfate therapy in patients with interstitial cystitis for relief of lower urinary tract symptoms: 15-year single center experience. · RESULTS

    pubmed:41472923:c45e9adab638:c45e9adab638

Study findings

In this PPS maculopathy case series, baseline severity (by stage) was mostly stage 1, with fewer stage 2 and stage 3 eyes.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    At presentation, 62.5% of eyes were stage 1, 31.3% stage 2, and 6.3% stage 3.

    Spectrum of Colopathy and Severe Polyposis Associated With Pentosan Polysulfate Sodium Maculopathy: A Retrospective Case Series. · RESULTS

    pubmed:41785987:1bfa6415ea64:1bfa6415ea64

Study findings

Uroflowmetry maximum flow rate was not significantly different over time following PPS treatment.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    For UFM parameters, postvoid residual decreased significantly over time (-1.052,P= 0.029), while maximum flow rate (0.093,P= 0.334) and voiding volume (0.751,P= 0.586) showed no significant differences.

    Efficacy and safety of pentosan polysulfate therapy in patients with interstitial cystitis for relief of lower urinary tract symptoms: 15-year single center experience. · RESULTS

    pubmed:41472923:c45e9adab638:c45e9adab638

Study findings

The label attributes anticoagulant activity and fibrinolytic effects to pentosan polysulfate sodium.

Regulatory record

1 cited source · 1 regulatory record

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    It has anticoagulant and fibrinolytic effects.

    ELMIRON®100 MG(PENTOSAN POLYSULFATE SODIUM)CAPSULES · General

    dailymed:f0ba651e-3d8a-11df-8fbe-119855d89593:d135d76fd516:d135d76fd516

Study findings

A blinded RCT in chronic interstitial cystitis reported a higher proportion achieving >50% bladder pain improvement with ELMIRON 100 mg TID over 3 months compared with placebo, with p = 0.005.

Regulatory record

1 cited source · 1 regulatory record

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    In this study, 28/74 (38%) of patients who received ELMIRON®and 13/74 (18%) of patients who received placebo showed greater than 50% improvement in bladder pain (p = 0.005).

    ELMIRON®100 MG(PENTOSAN POLYSULFATE SODIUM)CAPSULES · CLINICAL TRIALS

    dailymed:f0ba651e-3d8a-11df-8fbe-119855d89593:d135d76fd516:d135d76fd516

Study findings

Compared with placebo at Day 56, iPPS was associated with a decrease in ARGS, reported as an adjusted percent least squares mean difference with p = 0.028.

Human research · design must be checked

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    In iPPS-treated versus placebo-treated participants at Day 56, the adjusted change from baseline least squares mean difference of cartilage metabolism markers COMP and ARGS decreased -23.60% (-62.60, 15.40) and -56.60% (-106.59, -6.62; p = 0.028), respectively.

    Effects of pentosan polysulfate sodium on synovial fluid biomarkers in moderate to severe knee osteoarthritis: an exploratory, phase 2, randomized, double-blind, placebo-controlled trial. · RESULTS

    pubmed:41588475:ec022a0712b2:ec022a0712b2

Risks and interactions

Risks, organized for scanning.

Interactions

A controlled interaction study reported no meaningful difference in INR between warfarin plus placebo and warfarin plus pentosan polysulfate sodium (100 mg capsule every 8 hours for 7 days) when warfarin was titrated to INR 1.4 to 1.8.

Regulatory record

1 cited source · 1 regulatory record

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    INR for warfarin + placebo and warfarin + pentosan polysulfate sodium were comparable.

    ELMIRON®100 MG(PENTOSAN POLYSULFATE SODIUM)CAPSULES · Drug-Drug Interactions

    dailymed:f0ba651e-3d8a-11df-8fbe-119855d89593:d135d76fd516:d135d76fd516

Safety findings

A labeled safety warning reports retinal pigmentary changes (described as pigmentary maculopathy) identified with long-term ELMIRON use.

Regulatory record

1 cited source · 1 regulatory record

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    Pigmentary changes in the retina, reported in the literature as pigmentary maculopathy, have been identified with long-term use of ELMIRON®(seeADVERSE REACTIONS).

    ELMIRON®100 MG(PENTOSAN POLYSULFATE SODIUM)CAPSULES · WARNINGS

    dailymed:f0ba651e-3d8a-11df-8fbe-119855d89593:d135d76fd516:d135d76fd516

Products and regulatory status

Same ingredient. Different records.

Regulatory status

The labeled indication is symptom relief (bladder pain or discomfort) in interstitial cystitis.

Regulatory record

1 cited source · 1 regulatory record

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    ELMIRON®(pentosan polysulfate sodium) is indicated for the relief of bladder pain or discomfort associated with interstitial cystitis.

    ELMIRON®100 MG(PENTOSAN POLYSULFATE SODIUM)CAPSULES · INDICATIONS AND USAGE

    dailymed:f0ba651e-3d8a-11df-8fbe-119855d89593:d135d76fd516:d135d76fd516

Administration context

The practical clinical context.

Administration

The product is an oral capsule formulation containing 100 mg pentosan polysulfate sodium per capsule.

Regulatory record

1 cited source · 1 regulatory record

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record.

Evidence boundary: Applies only to the source-defined population, formulation, dose, and assessment period.

Exact passages, locators, and provenance
  1. supports · Source-backed record
    ELMIRON®is supplied in white, opaque hard gelatin capsules containing 100 mg pentosan polysulfate sodium, microcrystalline cellulose, and magnesium stearate.

    ELMIRON®100 MG(PENTOSAN POLYSULFATE SODIUM)CAPSULES · DESCRIPTION

    dailymed:f0ba651e-3d8a-11df-8fbe-119855d89593:d135d76fd516:d135d76fd516

Additional research & classification gaps

18 archived statements are kept separate from drug-effect findings. Media studies, economic models, methods, and records with unresolved scope are not used as medical-effect evidence.

Inspect contextual research (18)
Research-method context

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

The evaluation benchmarked multimodal large language model responses against human retinal specialist responses using standardized prompts informed by multimodal imaging and demographics, including PPS maculopathy cases.

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

The source compares complex size, stating PPS fraction complexes are smaller than complexes formed with UFH and LMWH.

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

The abstract reports a duration-dependent increase in PINK1 expression with PPS exposure.

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

The abstract reports dose-related functional impairment in RPE cells, with higher PPS doses associated with impaired phagocytosis measured by phagocytosis assays.

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

The abstract reports a dose-related impairment of mitochondrial respiration parameters (basal and maximal respiration) measured by Seahorse assay in ARPE-19 cells exposed to PPS.

Research context only—not evidence of a treatment effect.

Research-method context

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Constraining the response option set (restricted answer choices) improved multimodal large language model diagnostic performance metrics (accuracy and sensitivity) in this evaluation that included PPS maculopathy cases.

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Pentosan polysulfate (PPS) is described as a semisynthetic sulfated polysaccharide.

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

PPS is described as a heparin-like, sulfated polysaccharide, and its stated clinical indication is interstitial cystitis/bladder pain syndrome.

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

PPS is described as a semisynthetic, highly sulfated polysaccharide with structural similarity to heparin.

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

The source links thrombocytopenia to immunogenic structural features of multimeric complexes formed by heparin and PF4.

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Time-to-onset analyses summarize when events occur after exposure; Kaplan–Meier is nonparametric survival analysis and Weibull modeling can characterize hazard-rate changes over time.

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

In a cell-culture model using ARPE-19 cells, PPS exposure is reported to increase mitochondrial superoxide accumulation (a mitochondrial reactive oxygen species signal).

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

The abstract describes a characteristic structural imaging finding—hyperpigmented macular clumps localized to the RPE—in PPS maculopathy.

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

The authors interpret very short lifetime foci on FLIO as potentially marking early-stage or phenotypically distinct features of PPS maculopathy (hypothesis-level language: "may").

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

A characteristic imaging phenotype mentioned is an abnormal posterior-fundus autofluorescence pattern in PPS maculopathy.

Research context only—not evidence of a treatment effect.

Research-method context

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Using a retrospective dataset of clinical records plus multimodal retinal imaging, the study evaluated multimodal large language models’ ability to perform diagnostic classification specifically including PPS maculopathy versus phenotypic mimics.

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Despite the association, the abstract states the pathogenesis of PPS maculopathy is not yet established.

Research context only—not evidence of a treatment effect.

Research context · scope unclassified

1 cited source · Study independence not established

How to read this evidence

Sources and study IDs describe provenance, not clinical strength. Several articles can report the same study; one study can support several distinct findings. No clinical strength rating has been assigned here.

1 cited passage across 1 source record. 1 publication group(s) lack a resolved study identity.

Median time-to-onset summarizes the central tendency of reported onset latencies; it is descriptive for the analyzed subset and depends on report completeness.

Research context only—not evidence of a treatment effect.

Research status + gaps

What still needs better answers?

  • No publishable claim yet for: contraindication
  • 283 compiled claim(s) withheld by automated assurance: assurance_score_below_0.58 (120), assurance_score_below_0.72 (134), current_regulatory_source_required (74), extraction_ambiguity (153), high_risk_requires_regulatory_or_two_independent_sources (162), no_direct_support (254), proposal_not_staged (4)
  • A source-backed introductory overview is not yet available.

These are the limits of this profile, not an exhaustive list of scientific uncertainties.

References + discovery

Open the records yourself.

  1. ELMIRON®100 MG(PENTOSAN POLYSULFATE SODIUM)CAPSULES

    dailymed · published 2024-09-18 · retrieved 2026-09-09T08:45:04Z

  2. Pentosan polysulfate maculopathy: clinical considerations, pathobiology, and causality.

    pubmed · published 2025-11-01 · retrieved 2026-09-05T09:00:33Z

  3. Pigmentary Maculopathy in Patients with Interstitial Cystitis: Association with Pentosan Polysulfate and Other Therapies.

    pubmed · published 2026-01-01 · retrieved 2026-09-05T09:00:33Z

  4. Evaluating the clinical utility of multimodal large language models in rare maculopathy.

    pubmed · published 2025-12-03 · retrieved 2026-09-05T09:00:33Z

  5. Efficacy and safety of pentosan polysulfate therapy in patients with interstitial cystitis for relief of lower urinary tract symptoms: 15-year single center experience.

    pubmed · published 2025-12-01 · retrieved 2026-09-05T09:00:33Z

  6. Impact of Elmiron adjunct therapy on outcomes of fulguration in chronic interstitial cystitis in women.

    pubmed · published 2026-01-24 · retrieved 2026-09-05T09:00:33Z

  7. Effects of pentosan polysulfate sodium on synovial fluid biomarkers in moderate to severe knee osteoarthritis: an exploratory, phase 2, randomized, double-blind, placebo-controlled trial.

    pubmed · published 2026-01-26 · retrieved 2026-09-05T09:00:33Z

  8. Post-marketing safety of pentosan polysulfate sodium: a 21-year pharmacovigilance analysis of the FAERS database.

    pubmed · published 2025-01-01 · retrieved 2026-09-05T09:00:33Z

  9. Pentosan Polysulfate and Heparin Exhibit Comparable Interactions with Platelet Factor 4, Suggesting a Potential Risk of Thrombocytopenia.

    pubmed · published 2026-02-03 · retrieved 2026-09-05T09:00:33Z

  10. Effects of pentosan polysulfate sodium on joint structure and function out to six months in naturally-occurring canine osteoarthritis.

    pubmed · published 2026-01-01 · retrieved 2026-09-05T09:00:33Z

  11. Spectrum of Colopathy and Severe Polyposis Associated With Pentosan Polysulfate Sodium Maculopathy: A Retrospective Case Series.

    pubmed · published 2026-07-01 · retrieved 2026-08-29T08:37:13Z

  12. Late Development of Clinically Apparent Pentosan Polysulfate Maculopathy after Drug Cessation.

    pubmed · published 2026-04-01 · retrieved 2026-08-29T08:37:13Z

  13. Retinal Pigment Epithelium Injury in Pentosan Polysulfate Exposure: Morphologic Changes, Phagocytic Deficits, and Mitochondrial Dysfunction.

    pubmed · published 2026-03-31 · retrieved 2026-08-29T08:37:13Z

  14. Risk factors for pentosan polysulfate maculopathy.

    pubmed · published 2026-08-01 · retrieved 2026-08-29T08:37:13Z

  15. Retrospective study of visual acuity changes in patients with interstitial cystitis receiving pentosan polysulfate sodium.

    pubmed · published 2026-02-01 · retrieved 2026-09-05T09:00:33Z

  16. Characterization of Pentosan Polysulfate Sodium Maculopathy With Fluorescence Lifetime Imaging.

    pubmed · published 2026-05-15 · retrieved 2026-08-29T08:37:13Z

Publication history and provenance

Version 2 · Automated assessment · 2026-09-09T08:45:04Z

aa8c214c3bd4deca3cb2d782bbbdc8c7ce06ddde09e07003ca862c2753e7aa39