Despite its prevalence in patients of all ages, new treatments for osteoarthritis have been virtually non-existent for decades. Providers everywhere have prescribed physical therapy, NSAIDs, steroid or hyaluronic acid injections, joint arthroscopy (aka “clean out” surgeries) and eventual total joint replacements. While some of these treatment options have the ability to temporarily improve symptoms, none of them actually change the progression of the disease.
What about NSAIDs?
New research shows NSAIDs like ibuprofen and naproxen are associated with loss of joint space, potential cartilage toxicity and inhibition of bone and soft tissue healing.
What about hyaluronic acid (Synvisc, Hyalgan, rooster comb) injections?
A recent review of 169 studies involving 21,000+ patients found that while entirely non-toxic to the joint, injections utilizing hyaluronic acid are not associated with a clinically relevant reduction in pain intensity in the majority of patients.
What about arthroscopy to “clean out” the knee joint?
Studies suggest that while arthroscopic surgery of an arthritic joint may provide some immediate relief, it can harm the overall health of the joint long-term.
What about joint replacement?
The British Medical Journal determined that knee replacements should be limited to only the most severely affected patients and avoided whenever possible.
What can Pentosan do that nothing else can?
A disease modifying drug is one that delays or slows the progression of a disease by targeting its underlying cause. There are currently zero disease modifying osteoarthritis drugs (DMOADs) on the market. Research demonstrates that Pentosan stops the structural changes within arthritic joints, and subsequently, greatly improves symptoms like stiffness and pain by treating the underlying cause. This research has allowed for the proposal of Pentosan injections as the first ever disease-modifying osteoarthritis drug to hit the market.
Pentosan polysulfate is the first drug to obtain fast-track designation by the FDA for approval as a DMOAD. While the injectable form is not yet FDA approved for the treatment of osteoarthritis (and thus, not covered by insurance), its oral form is FDA approved and well-tolerated as a treatment for interstitial cystitis (a bladder pain condition). Given its established safety and tolerability, our office continues to offer this injectable treatment for osteoarthritis.
How exactly does Pentosan work?
Pentosan reduces cartilage degradation by directly and indirectly influencing inflammatory chemicals. Pentosan increases the available proteins used in keeping cartilage healthy. In addition to mitigating inflammation, Pentosan increases the viscosity (thickness) of joint fluid to better cushion the joint. Its mild blood-thinning properties improve blood flow to bones, cartilage and joint fluid for improved healing and recovery.
Following 6 weeks of Pentosan injection therapy, 80% of patients report feeling either moderately better with a slight but noticeable change, better with a definite improvement that has made a real and worthwhile difference, or a great deal better with a considerable improvement that has made all the difference in at least one of the following three categories: (1) pain with knee flexion, (2) pain with walking and (3) pain with stair climbing for one year following treatment. It was concluded that Pentosan therapy for the treatment of mild osteoarthritis of the knee provided improvements in the clinical assessments and type 2 collagen levels necessary for healthy joint cartilage.
Who may it help?
Pentosan may benefit current osteoarthritis patients and those who are at high-risk for developing osteoarthritis. This patient population include athletes, those with a genetic predisposition or those with careers and hobbies that involve standing for long periods on hard floors or high-impact activities.
What to do next?
If you’d like to learn more, give our office a call and we will be happy to meet and discuss how Pentosan can help you.
Testimonial:
“After taking handfulls of Tylenol, Aleve, Naproxan and other over the counter pain relievers for years, I am absolutely thrilled with the results of the injections for Pentosan Polysulfate. What a wonderful difference. I can actually walk into the store before I start looking for a cart to lean on, walk more on my treadmill, and take my dog walking a couple of times a day riding my bike. I am sleeping so well without waking all through the night because of joint aches. I have not taken any over the counter medications since doing the injections, other than the occasional one as my arthritis is very much affected by the weather.”