Osteoarthritis treatment with Pentosan
Pentosan polysulfate is derived from beech wood trees and has been approved in Australia for human use for the treatment of Interstitial cystitis. It also stimulates re-growth of new cartilage in the joint which can treat osteoarthritis. It does this by promoting cartilage synthesis and inhibits its breakdown. It also improves the bio-synthesis of high molecular weight hyaluronan, a key component of joint fluid. And finally, it increases blood flow through the capillaries that serve the cartilage cells themselves. If you increase blood flow to these cells, they’re more likely to stay healthy and arthritis-free; there’s increasing suspicion that poor blood flow itself may be a major contributor to osteoarthritis.
For anyone, patient or physician, familiar with the suffering from arthritis, this is an extraordinary discovery. The amount of time it takes to regenerate enough cartilage to be pain free depends upon where in the body the arthritis is located. Since the hip joint is the largest joint, it takes the longest to repair. The knee joint will take less time, and the hands and spine will respond the quickest. Essentially, you use the product until you are out of pain.
Pentosan has long been available orally for Interstitial cystitis however it exhibits poor absorption so Dr. Roby Mitchell (Dr Fit), a US doctor, developed pentosan nasal spray back in the early 2000’s when we first became aware of its potential to treat osteoporosis. He has had a great deal of success with many patients – even those well into their 80′s.
A double-blind trial using pentosan polysulfate was undertaken in 43 patients with knee arthrosis of Severity I and II (Engel & Juhran, 1982). After a washout period of three days, the drug (100mg) was administered intramuscularly to half the group according to the following protocol: days 1-3, one injection (100mg) daily; day 4, no drug treatment; Days 5-27, one injection (100mg) every second day. This represented a total of 15 injections or 1500mg of pentosan polysulfate or the placebo solution. The patient response was assessed using a 1-5 pain scale of both subjective and objective criteria which included pain at rest, pain during movement, activity limitation of movement, passive limitation of movement and pain caused by fatigue. Overall assessment by the physician and patients on a weekly basis showed an improvement in all clinical criteria measured over the four week study period in the drug-treated group relative to the placebo group.
A double-blind, placebo-controlled clinical study in 105 patients with osteoarthritis of the knee has been performed in Perth, Australia (Edelman et al. 1994) where patients either received a salt solution or pentosan polysulphate at 3mg/kg as an intramuscular injection once weekly for 4 weeks. In the pentosan polysulphate treated patients, stiffness significantly improved after the first week and pain on walking or at rest, time to walk upstairs and overall pain significantly improved after the first month. Pain at rest and step time were still significantly better than the placebo group after 2 months.
A preliminary report has been published (Rasaratnam et al., 1996) of a double-blind placebo controlled study of intra-articular pentosan polyfulphate (0 or 50mg per joint once weekly for 4 weeks) in 50 patients suffering osteoarthritis of the knee. Even with 31 of the 50 patients evaluated, there were significant improvements in pain and mobility for up to 2 months after completing the treatment.
More recently results from clinical trials conducted by Paradigm Biopharma in Australia further indicate that Pentosan Polysulfate Sodium may be a groundbreaking medication for the treatment of osteoarthritis and sports injuries. The numbers from the clinical trials are incredibly promising, with 70% of patients experiencing a significant reduction of arthritis pain and another 15% having a positive initial response before being restricted further dosages by the trial. Pentsan polysuflphate is currently undergoing double-blind clinical trials for the management of the osteoarthritis patient in a number of other countries.
Pentosan has been available from our laboratory on prescription since 2005 so is not considered a new breakthrough by us as we have long been aware of its benefits.
Pentosan is available from us on prescription in a number of dose forms:
(1) Nebules are available where the medication is administered with the use of a nebuliser to deliver it deep into the lung where it is effectively taken up into systemic circulation and transported around the body.
(2) Pentosan Injections are also available which are injected subQ weekly.
(3) Pentosan Nasal Spray which is inhaled daily
Pentosan carries no toxicity. It will create a mild blood thinning effect, so patients taking any blood thinning medication or more than 81 mg of aspirin/day should discuss this with their doctor.
Patients would be best advised to refrain from simultaneously using non-steroidal anti-inflammatories, since it has been well demonstrated this class of drugs actually impairs the ability of our body to re-grow new cartilage.