Long-term efficacy and tolerability of pentosan polysulphate sodium in the treatment of bladder pain syndrome

Al-Zahrani, Ali A.; Gajewski, Jerzy

doi:10.5489/cuaj.10095

Cited by 36 publications

(18 citation statements)

References 27 publications

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“…At a mean followup of 22 months, Alzharani et al 91 found that 54.2% of patients treated with PPS reported a >50% improvement in symptoms, whereas Jepsen et al 92 reported only 6.2-18.7% of patients maintained a benefit after 18 months of treatment.…”

Section: Pentosan Polysulfate (Pps) (Option Grade D)mentioning

confidence: 99%

CUA guideline: Diagnosis and treatment of interstitial cystitis/ bladder pain syndrome

Cox

Golda

Nadeau

et al. 2016

CUAJ

115

121

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MethodologyThe following guidelines were based on MEDLINE and PUBMED searches of English language literature, in addition to consensus conference proceedings. Levels of evidence and grades of recommendation were assigned for each investigation and treatment, as per the modified Oxford Centre for Evidence-Based Medicine grading system. Where the literature was inconsistent or scarce, a consensus expert opinion was generated to provide treatment guidelines.

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Section: Pentosan Polysulfate (Pps) (Option Grade D)mentioning

confidence: 99%

CUA guideline: Diagnosis and treatment of interstitial cystitis/ bladder pain syndrome

Cox

Golda

Nadeau

et al. 2016

CUAJ

115

121

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show abstract

“…In humans, long-term clinical use of PPS is extremely well tolerated and highly efficacious for periods greater than 12 months (53). Alphaviruses can produce chronic musculoskeletal ailments over a prolonged period of time.…”

Section: Table 2 Long-term Pps Treatment Decreases the Expression Of mentioning

confidence: 99%

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

Herrero

Foo

Sheng

et al. 2015

J Virol

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Arthritogenic alphaviruses such as Ross River virus (RRV) and chikungunya virus (CHIKV) cause large-scale epidemics of severe musculoskeletal disease and have been progressively expanding their global distribution. Since its introduction in July 2014, CHIKV now circulates in the United States. The hallmark of alphavirus disease is crippling pain and inflammation of the joints, a similar immunopathology to rheumatoid arthritis. The use of glycans as novel therapeutics is an area of research that has increased in recent years. Here, we describe the promising therapeutic potential of the glycosaminoglycan (GAG)-like molecule pentosan polysulfate (PPS) to alleviate virus-induced arthritis. Mouse models of RRV and CHIKV disease were used to characterize the extent of cartilage damage in infection and investigate the potential of PPS to treat disease. This was assessed using histological analysis, real-time PCR, and fluorescence-activated cell sorting (FACS). Alphaviral infection resulted in cartilage destruction, the severity of which was alleviated by PPS therapy during RRV and CHIKV clinical disease. The reduction in cartilage damage corresponded with a significant reduction in immune infiltrates. Using multiplex bead arrays, PPS treatment was found to have significantly increased the anti-inflammatory cytokine interleukin-10 and reduced proinflammatory cytokines, typically correlated with disease severity. Furthermore, we reveal that the severe RRV-induced joint pathology, including thinning of articular cartilage and loss of proteoglycans in the cartilage matrix, was diminished with treatment. PPS is a promising new therapy for alphavirus-induced arthritis, acting to preserve the cartilage matrix, which is damaged during alphavirus infection. Overall, the data demonstrate the potential of glycotherapeutics as a new class of treatment for infectious arthritis. IMPORTANCEThe hallmark of alphavirus disease is crippling pain and joint arthritis, which often has an extended duration. In the past year, CHIKV has expanded into the Americas, with approximately 1 million cases reported to date, whereas RRV continues to circulate in the South Pacific. Currently, there is no licensed specific treatment for alphavirus disease, and the increasing spread of infection highlights an urgent need for therapeutic intervention strategies. Pentosan polysulfate (PPS) is a glycan derivative that is orally bioavailable, has few toxic side effects, and is currently licensed under the name Elmiron for the treatment of cystitis in the United States. Our findings show that RRV infection damages the articular cartilage, including a loss of proteoglycans within the joint. Furthermore, treatment with PPS reduced the severity of both RRV-and CHIKV-induced musculoskeletal disease, including a reduction in inflammation and joint swelling, suggesting that PPS is a promising candidate for drug repurposing for the treatment of alphavirus-induced arthritis.A rthropod-borne arthritogenic alphaviruses such as Ross River virus (RRV) and chikungu...

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“…Sodium pentosan polysulfate is a semisynthetic glycosaminoglycan and its pharmacology is poorly understood although previous in vitro studies have shown that it can inhibit mast cell histamine release and may, via an indirect mechanism, reduce urothelial responses to inflammatory stimuli [10]. Its use in interstitial cystitis/painful bladder syndrome has been well documented in randomised control trials [8,11]. Sodium pentosan polysulfate is given orally, and approximately 5% is excreted in the urine.…”

Section: Discussionmentioning

confidence: 98%

Introduction of sodium pentosan polysulfate and avoidance of urethral catheterisation: improved outcomes in children with haemorrhagic cystitis post stem cell transplant/chemotherapy

Duthie¹,

Whyte²,

Chandran³

et al. 2012

Journal of Pediatric Surgery

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Long-term efficacy and tolerability of pentosan polysulphate sodium in the treatment of bladder pain syndrome

Cited by 36 publications

References 27 publications

CUA guideline: Diagnosis and treatment of interstitial cystitis/ bladder pain syndrome

CUA guideline: Diagnosis and treatment of interstitial cystitis/ bladder pain syndrome

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

Introduction of sodium pentosan polysulfate and avoidance of urethral catheterisation: improved outcomes in children with haemorrhagic cystitis post stem cell transplant/chemotherapy

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