Characterization of pentosan polysulfate patients for development of an alert and screening system for ophthalmic monitoring

Pentosan polysulfate (PPS; ELMIRON, Janssen Pharmaceuticals, Titusville, NJ) is a U.S. Food and Drug Administration–approved oral medication for interstitial cystitis. Numerous reports have been published detailing retinal toxicity with the use of PPS. Studies characterizing this condition are primarily retrospective, and consequently, alert and screening systems need to be developed to actively screen for this disease. The goal of this study was to characterize ophthalmic monitoring trends of a PPS-using patient sample to construct an alert and screening system for monitoring this condition. A single-institution retrospective chart review was conducted between January 2005 and November 2020 to characterize PPS use. An electronic medical record (EMR) alert was constructed to trigger based on new PPS prescriptions and renewals offering ophthalmology referral. A total of 1407 PPS users over 15 years was available for characterization, with 1220 (86.7%) being female, the average duration of exposure being 71.2 ± 62.6 months, and the average medication cumulative exposure being 669.7 ± 569.2 g. A total of 151 patients (10.7%) had a recorded visit with an ophthalmologist, with 71 patients (5.0%) having optical coherence tomography imaging. The EMR alert fired for 88 patients over 1 year, with 34 patients (38.6%) either already being screened by an ophthalmologist or having been referred for screening. An EMR support tool can improve referral rates of PPS maculopathy screening with an ophthalmologist and may serve as an efficient method for longitudinal screening of this condition with the added benefit of informing pentosan polysulfate prescribers about this condition. Effective screening and detection may help determine which patients are at high risk for this condition. Le polysulfate de pentosan sodique (PPS; ELMIRON, Janssen Pharmaceuticals, Titusville, New Jersey) est un médicament oral approuvé par la Food and Drug Administration américaine dans le traitement de la cystite interstitielle. Or, de nombreux rapports publiés font état de la toxicité rétinienne du PPS. Les études à ce sujet étant surtout de nature rétrospective, des systèmes d'alerte et de dépistage doivent être mis en place pour surveiller activement l'apparition de cet effet secondaire. Notre étude avait pour objectif de dépeindre les tendances en matière de surveillance ophtalmologique au sein d'un échantillonnage de patients qui reçoivent le PPS afin de mettre sur pied un système d'alerte