Advances in the clinical applications of sodium thiosulphate

BACKGROUND: Sodium thiosulphate (STS) is a clinically approved pharmaceutical agent known for its antioxidant and sulphide-releasing properties. Currently, it is commonly employed in the detoxification treatment of various chemical intoxications, including cyanide, arsenic, and lead poisoning. In recent years, research into the clinical applications of STS has advanced rapidly, resulting in numerous significant breakthroughs. However, awareness and adoption of these developments remain limited among clinical practitioners. DISCUSSION: In addition to its research progress in the treatment of cyanide poisoning, STS has also demonstrated protective effects against chemotherapeutic drug-induced ototoxicity and nephrotoxicity, as well as in conditions such as vascular calcification and uraemic pruritus. Furthermore, STS has been shown to exert protective effects on multiple organs, including the heart, brain, and kidneys, by mitigating ischaemia-reperfusion injury. There is also evidence suggesting that STS may offer protection in diseases such as preeclampsia and hypertensive renal injury. However, these studies exhibit considerable variability in terms of STS administration strategies. CONCLUSIONS: This paper provides a comprehensive review of current preclinical and clinical studies on STS, with the aim of highlighting its potential therapeutic applications in chemical intoxications, cancer treatment, vascular calcification, uraemic pruritus, and other related pathological conditions. Owing to its multiple biological protective effects and a favourable safety profile, STS is anticipated to receive growing recognition among the medical community, which may pave the way for the exploration of novel clinical indications and contribute meaningfully to public health.