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

Liu X, Virk S, Fedorova T, et al. · Osteoarthritis and Cartilage Open

The primary outcome, serum triglycerides, did not change (1.10 to 1.17 mmol/L at week 16). Total cholesterol fell from 6.23 to 5.95 mmol/L at week 16 (P=0.01) and LDL from 4.03 to 3.82 (P=0.009), with no significant LDL change at week 26. Knee pain NRS fell from 6.39 to 4.18 at week 6, 3.63 at week 16 and 4.38 at week 26, and every KOOS subscale improved (P<0.001), but the authors note the changes were of the size seen in placebo arms of recent knee-OA trials. MRI bone-marrow-lesion and synovitis scores did not change over 26 weeks. Nine positive faecal occult blood tests were the commonest adverse event.

Population

38 adults (of 56 screened) aged 45 or over with symptomatic Kellgren-Lawrence grade 2–3 knee OA and primary hypercholesterolaemia, mean age 62, 71% women, Royal North Shore Hospital, Sydney

Intervention

Oral PPS 10 mg/kg every 4 days, two 5-week cycles

Comparator

None (single-arm, open-label)

Limitations

Uncontrolled, open-label, small, and powered only for the triglyceride endpoint; pain was a secondary outcome the paper calls exploratory. Funded by Sylvan Scientific, which supplied the drug and reviewed the manuscript.