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• W4243089985 abstract "We thank Drs VanderBeek and Jain for their comments on our article, which investigated whether exposure to pentosan polysulfate sodium (PPS) was associated with diagnosis of maculopathy in a large cohort of patients with interstitial cystitis.1Ludwig C.A. Vail D. Callaway N.F. et al.Pentosan polysulfate sodium exposure and drug-induced maculopathy in commercially insured patients in the United States.Ophthalmology. 2020; 127: 535-543Abstract Full Text Full Text PDF Scopus (24) Google Scholar We did not identify any statistically significant relationship between exposure to PPS and risk of maculopathy diagnosis. Although the patients in our sample had much less lifetime exposure to PPS on average than the patients in 2 case series of PPS maculopathies, it is worth knowing whether maculopathy risk is elevated in a cohort of patients that may be more representative of the typical PPS user.2Pearce W.A. Chen R. Jain N. Pigmentary maculopathy associated with chronic exposure to pentosan polysulfate sodium.Ophthalmology. 2018; 125: 1793-1802Abstract Full Text Full Text PDF PubMed Scopus (86) Google Scholar,3Hanif A.M. Armenti S.T. Taylor S.C. et al.Phenotypic spectrum of pentosan polysulfate sodium-associated maculopathy: a multicenter study.JAMA Ophthalmol. 2019; 137: 1275-1282Crossref PubMed Scopus (53) Google Scholar We strongly agree with VanderBeek and Jain on the following points. First, our findings do not contradict the findings from the case reports, which include patients with much longer follow-up and with many more years of exposure to PPS. Second, our findings do not rule out the possibility of a relationship between short-term PPS exposure and risk of maculopathy. This cohort could go on to develop maculopathies in the future, and patients may have had maculopathies that were not diagnosed, either because they did not receive eye examinations or because PPS maculopathy is difficult to observe in its early stages. However, it is worth reiterating the conclusion of our study: in this retrospective analysis of administrative claims data, we do not observe an association between PPS exposure and diagnosis with maculopathy. VanderBeek and Jain have recently published a study similar to our own using another large administrative database.4Jain N. Li A.L. Yu Y. VanderBeek B.L. Association of macular disease with long-term use of pentosan polysulfate sodium: findings from a US cohort.Br J Ophthalmol. 2019 Nov 6; (pii: bjophthalmol-2019-314765) ([Epub ahead of print])https://doi.org/10.1136/bjophthalmol-2019-314765Crossref Scopus (41) Google Scholar They do not find a statistically significant relationship between PPS exposure and risk of maculopathy in a cohort with 5 years of follow-up, but do identify an association when restricting to a cohort with 7 years of follow-up. It is not clear to us whether this association would be statistically significant at a threshold that corrects for multiple comparisons, or whether these findings would be present in time-to-event analyses. We are hesitant to refer to nonsignificant findings as trends. We do not dispute that there is compelling evidence that a cohort of patients with long-term exposure to PPS have concerning maculopathy diagnoses. However, we would caution against interpreting the results of either published administrative database study as evidence of a connection between PPS and maculopathy. Re: Ludwig et al.: Pentosan polysulfate sodium exposure and drug-induced maculopathy in commercially insured patients in the United States (Ophthalmology. 2020;127:535–543)OphthalmologyVol. 127Issue 5PreviewIn this study of insurance claims data by Ludwig et al, the authors found no association between pentosan polysulfate sodium (PPS) use and a diagnosis of macular disease at 5 years.1 Although this appears to contradict our earlier reports on the association, the findings are not unexpected. Full-Text PDF" @default.
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• W4243089985 doi "https://doi.org/10.1016/j.ophtha.2020.01.005" @default.
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