Sodium pentosan polysulfate resulted in cartilage improvement in knee osteoarthritis--an open clinical trial

Kumagai K, Shirabe S, Miyata N, Murata M, Yamauchi A, Kataoka Y, Niwa M · BMC Clinical Pharmacology

Joint effusions settled quickly, pain and knee flexion improved and stayed improved to week 52, and serum C2C (a collagen-degradation marker) fell about 20% — but weight-bearing radiographs at one year showed neither improvement nor degeneration, and with no control arm none of it is attributable to the drug.

Population

20 women with mild-to-moderate knee OA (Kellgren-Lawrence 1–3, mostly grade 2), Nagasaki University Hospital

Intervention

Subcutaneous PPS (SP54) 2 mg/kg weekly for 6 weeks, followed to one year

Comparator

None (single-arm, open-label)

Limitations

Open-label, uncontrolled, 20 patients; despite the title, the 'cartilage improvement' was a blood biomarker, not imaged structure; clotting times were measurably prolonged one hour after each injection.