Treatment Persistence of Pentosan Polysulfate: 4 year follow-up Real World Data from A Korean National Cohort Database

초록

Introduction & Objectives: Pentosan polysulfate sodium (PPS) is a key treatment for interstitial cystitis/bladder pain syndrome (IC/BPS),a chronic disease that often requires long-term management. While the persistence of other urologic medications has been well-documented,PPS persistence has not been widely studied in real-world settings. Given the chronic nature of IC/BPS, it is crucial to understand how longterm patients can sustain PPS treatment. This study aimed to evaluate the persistence rates of PPS using data from the Korean NationalHealth Insurance Database over a maximum follow-up period of 4 years. Materials & Methods: This retrospective analysis included patients aged 18 or older who had their first PPS prescription for IC/BPSbetween January 1, 2018, and December 31, 2018. The index date was defined as the date of the first PPS prescription. A 6-month pre-indexperiod ensured eligibility. Treatment persistence was defined as the time from the index date to discontinuation. Persistence rates wereevaluated at 1, 2, 3, 6, and 12 months, as well as at 2, 3, and 4 years. The median follow-up and persistence periods were presented withinterquartile ranges (IQR). This study received approval from the Ethical Committee of the Korea University Hospital. Results: A total of 16,474 patients were included, with a median follow-up of 1257 days. The median persistence for PPS was 31 days (IQR14–101). Persistence rates were 55.07% at 1 month, 37.53% at 2 months, 29.07% at 3 months, 21.56% at 6 months, 17.59% at 1 year,8.12% at 2 years, 2.71% at 3 years, and 1.53% at 4 years (fig. 1). Conclusions: This is the first study to evaluate PPS persistence in real-world clinical practice. The 1-year persistence rate of 17.59% issignificantly lower than that of other commonly prescribed urinary drugs, with less than 1% of patients continuing treatment beyond 4 years.These results indicate that most patients discontinue PPS early, highlighting the need for regular monitoring and alternative treatmentstrategies for IC/BPS.