LONG-TERM EXPERIENCE WITH PENTOSANPOLYSULFATE IN INTERSTITIAL CYSTITIS

Objectives. An oral preparation of pentosanpolysulfate sodium (PPS) wa s recently approved by the Food and Drug Administration for interstiti al cystitis (IC). Previously published articles have documented improv ement in symptoms in 28% to 63% of patients, but no long-term studies have been published. No unique characteristics except for Hunner's ulc er have been found in patients experiencing relief from PPS. We report our experience with PPS following patients up to 116 months and analy ze baseline parameters in an attempt to characterize long-term respond ers. Methods. Baseline and follow-up data from 97 patients with IC and enrolled in a compassionate use study with PPS at the University of W isconsin from 1987 to 1995 are analyzed. Previous treatments had faile d, and patients had to pay for PPS. Patients continuing treatment with PPS were monitored every 3 months with questionnaires and laboratory tests. In 1996 an update on medication and a questionnaire developed b y the National Institutes of Health Interstitial Cystitis Database wer e sent to patients who had discontinued treatment. Results. By the end of the study period 11 (11.3%) of the patients were still taking PPS, with 6 (6.2%) doing so continuously for more than 18 months. Three (3 %) patients who discontinued PPS were in long-term remission. An addit ional 15% had remission for a substantial period. Except for a weak co rrelation between less constant pain (P = 0.0439), no correlations wer e found between baseline parameter; and duration of treatment with PPS . Conclusions. On a long-term basis, between 6.2% and 18.7% of patient s with IC benefit from PPS. The only baseline factor predicting respon se to PPS was less constant pain. (C) 1998, Elsevier Science Inc. All rights reserved.