The effect of pentosan polysulfate sodium for improving dyslipidaemia and knee pain in people with knee osteoarthritis: A pilot study

by Selleckchem | Apr 18 2023

Objective: To evaluate the efficacy and safety of pentosan polysulfate sodium (PPS, Elmiron®) for dyslipidaemia and knee osteoarthritis (OA) related symptoms.

Method: This was a single-arm, open-label, prospective, non-randomised pilot study. People with painful knee OA and a history of primary hypercholesterolemia were included. PPS was taken orally in a dosage of 10 mg/kg once every 4 days for 5 weeks for two cycles. There was 5 weeks of no medication between the cycles. The main outcomes included the change in lipidemia levels, the change in knee OA-related symptoms assessed by pain numerical rating scale (NRS) and Knee Osteoarthritis Outcome Score (KOOS), and knee MRI semi-quantitative score. The changes were analysed using paired t-tests.

Results: 38 participants were included, with a mean age of 62.2 years. We found a statistically significant decrease in total cholesterol (from 6.23 ± 0.74 to 5.95 ± 0.77 mmol/L; P = 0.01) and low-density lipoprotein (from 4.03 ± 0.61 to 3.82 ± 0.61 mmol/L; P = 0.009) from baseline to week 16. Knee pain NRS was significantly reduced at weeks 6, 16 and 26 from 6.39 ± 1.33 to 4.18 ± 1.99, 3.63 ± 2.28 and 4.38 ± 2.55, respectively (P < 0.001). However, there was no significant difference in terms of the primary outcome of triglyceride levels before and after treatment. The most common AEs were positive faecal occult blood tests, followed by headache and diarrhoea.

Conclusion: The findings suggest that PPS has promising effects on improving dyslipidaemia and symptomatic pain relief in people with knee OA.

Comments：

The study was a single-arm, open-label, prospective, non-randomized pilot study that aimed to evaluate the efficacy and safety of pentosan polysulfate sodium (PPS, Elmiron®) for dyslipidaemia and knee osteoarthritis (OA)-related symptoms. The study included 38 participants with painful knee OA and a history of primary hypercholesterolemia. PPS was taken orally in a dosage of 10 mg/kg once every 4 days for 5 weeks for two cycles, with a 5-week break between the cycles.

The study found a statistically significant decrease in total cholesterol and low-density lipoprotein from baseline to week 16. Knee pain NRS was significantly reduced at weeks 6, 16 and 26. However, there was no significant difference in triglyceride levels before and after treatment. The most common adverse events were positive faecal occult blood tests, followed by headache and diarrhea.

The study suggests that PPS may have promising effects on improving dyslipidemia and providing symptomatic pain relief in people with knee OA. However, the results should be interpreted with caution due to the study's limitations, such as its small sample size, lack of a control group, and potential biases introduced by the study design. Further studies with larger sample sizes and more rigorous study designs are needed to confirm these findings.