Pentosan Polysulfate Maculopathy Following Subcutaneous Injections for Arthritis

Fung AT, Sarraf D, Carrillo JM, Feo A, Faghihi S, Borie CM, Lim L, Hunyor AP, Yannuzzi NA · JAMA Ophthalmology

The first published maculopathy cases from injectable PPS: three patients developed the classic pigmentary maculopathy after subcutaneous courses totalling 45.5 to 96 grams over 7 to 10 years — far below the kilogram-scale oral exposures of earlier series, which the authors attribute to roughly ten-fold higher subcutaneous bioavailability. Maculopathy progressed even after stopping the drug.

Population

Three arthritis patients (US and Australian centers) treated with subcutaneous PPS

Intervention

Repeated subcutaneous PPS for osteoarthritis or inflammatory arthritis over 7–10 years, cumulative 45.5–96 g

Comparator

None

Limitations

Three cases with retrospectively reconstructed exposure; full text embargoed at the time of recording, so drawn from the structured abstract; the bioavailability figure is the authors' explanation, not a measurement in these patients.