Sodium pentosan polysulfate (PPS) — Treatment for pain in people with osteoarthritis of the knee

#1

I just heard about this. If knee pain is restricting exercise, check this out. Also other benefits claimed in anti cancer and more. Very interesting.

Treatment for pain in people with osteoarthritis of the knee and lesions in the subchondral bone (the layer of bone just below the cartilage in joints which acts as a so-called “shock-absorber”) is limited.

Pentosan or Sodium pentosan polysulfate (PPS) is a medication used in humans for more than 60 years. It is a semi-synthetic complex carbohydrate manufactured from European beech xylans and is well tolerated by the body.

Currently, the use of Pentosan is considered “off-label” for osteoarthritis.

When injected twice per week for 6 weeks, Pentosan has been shown to improve painful bone marrow lesions under worn cartilage in knee osteoarthritis patients. The agent being developed by Paradigm Pharmaceuticals is called Xilosul and requires TGA special access scheme approval while clinical trials are underway, because it is currently an off-label medication given via subcutaneous injection (similar to insulin injections into the skin of the thigh or stomach). Pentosan is not injected into the joint and therefore must have a systemic (whole body) effect on Osteoarthritis, suggesting there are systemic causes for the disease.

Podcast where this is discussed. Also has antiviral, anti cancer (prostate cancer mentioned), anti arteriosclerosis, gut health benefits. Oral (best for GI issues) and injectable forms (best for joint issues)

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#2

@Joseph_Lavelle have you found a source for this off label use? I have been interested in this for the last 3 or 4 years but l only come across a pill form for cystitis.

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#3

Dr. Elizabeth Yurth in Boulder CO

Check out the podcast link for contact info. It is available to any doctor who will prescribe it off label.

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#4

@Justin Check this out. Dr Yurth specifically mentions using this drug (off label) for prostate cancer.

#5

Pill form is Cheap from India pharmacies…

Sodium pentosan polysulfate

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#6

@RapAdmin Perfect. The dosage for oral Sodium pentosan polysulfate is 25mg. Dr Yurth spoke of using compounding pharmacies to get this low dose to avoid side effects.

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#7

Make sure you read about pigmented maculopathy prior to using Pentosan. I’ve used subq Pentosan for knee arthritis and would love to continue it but the risk of pigmented maculopathy outweighs the benefits in my mind.

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#8

@shady. Dr Yurth speaks to this risk in the podcast episode I linked in this thread. She says her protocol stays well below the cumulative dosage that leads to the eye issue. I’d reach out to Dr Yurth if I needed this sort of help. I hope it works out.

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#9

Yes I agree on cumulative dose. What they fail to mention is that presumed bioavailability with injections is 100%. PO bioavailability for oral Pentosan is very poor thus a massive dose and duration has been noted prior to development of pigmented maculopathy. Take the PO dose and multiple by the presumed bioavailability and compare that to cumulative injection dose.

Not saying it’s not a drug with potential for arthritis, but if you damage your retina it isn’t coming back. Even after d/c of Pentosan the maculopathy progresses.

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#10

FYI
For anyone interested in this treatment, the price l was ballparked for a 3 month supply through Dr. Yurth’s clinic would be around $1000.00. 250$ for a consultation and around $750 for the prescription.

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#11

A “for profit” model. Big profit.

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#12

Joseph, I got mine from a place called “firstchoiceequine”, Pentosan Gold 50 ml
SKU: PENTG-50 Pris: $199.99, I live in Canada we have tight border restrictions, so was very happy to get it. Based on my own research I don’t think tablets are the way to go, I injected Pentosan into my injured back, my injured knee and my arthritic fingers, the long and the short of it is its very helpful. I fixed all my joint issues eventually, using a combination of senolytic treatment, pentosan, and MSC placental exosomes. I hate to think about the state I would be in otherwise.

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#13

@Bruce good to know. Thanks

#14

Bruce, did you post your exact regimen anywhere, to try to resolve your issues with arthritis, or would you perhaps be willing to share it? I have a family member with very concerning arthritic problems. Many thanks in advance!

#15

Pat, this is what worked for me. Background in my 20s, I injured my lower back, nearly breaking my neck, and by 50, I had chronic lower back pain. My fingers started showing mild arthritic symptoms, and at 52 damage knee cartilage in one knee caused constant but moderate pain.

A few years ago, I did my first five-day fast, during day 3-5 while in ketosis took senolytics—200mg of Dasatinib with 2000mg of Quercetin, it made the fast even less enjoyable however post-fast, my finger arthritis disappeared.

However, my back and knee were very problematic for me. I tried various treatments like HGH injections, hyperbaric therapy, Cartalax peptides, red light therapy, all of which I think helped a bit to keep things stable.
Counter intuitively what I didn’t find helpful was prolotherapy or exercise. Prolo did nothing, exercise seemed to aggravate things.

June 2023 I got my hands on Pentosan, I injected it deeply into my knee joint, with my lower back I injected it using a ½ needle as deep as it would go into and all around the trouble area, within 2 days in both regions it extinguished a lot of the pain. I repeated this about four times over several months. Pentosan is definitely worth while.

Later in 2023 after watching all of Dr. Ed Parks’ youtube videos on MSC placental exosomes, I was able to source some. I Injected them into my knee and lower back, in the same fashion. I noticed an immediate improvement— in fact my back pain disappeared the following day, 100 percent, almost like a miracle, and my knee felt like it was healing. This lasted a few months, then the pain eventually started to return, each time in a milder form, and each time I just used more exosomes.

Currently, I am convinced my knee is fully healed. My fingers are good.

Occasionally, my back gets slightly sore, the last time that happened I applied a small dosage of exosomes mixed with DMSO topically and that has done the job, I have been pain free for months now.

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#16

What exosomes if I might ask?

#17

I used exovex, I can only say good things about the product.

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#18

@Bruce,

A recent x-ray showed severe osteo under my kneecap, but I’m not in any pain, even with hard running. I did, though, have a “spontaneous” infection beneath the patella, which may be related. Do you think I should hold off on pentosan until I need it–if I need it–or would you take a more proactive approach?

Are exosomes hard to obtain? Are they expensive?

You seem to have benefitted equally from exsomes and pentosan. Correct?

Did you try BPC-57 or TB-500?

#19

Tim, I am glad to hear you have no pain, I really can only share what worked for me, you have to understand I was getting a bit desperate.

You will have a difficult time getting exosomes, unless you find a practitioner who works with them. I should also mention I tried ASCE plus freeze dried exosomes from Korea, I think derived from fat cells those did helped a bit pain wise.

Yes I did use BPC-157 and Thymosin Beta 4 on my knee, at times I also combined that with HGH, It seemed to help a small bit, but my knee just didn’t get better and then it would get worse.

I do have good things to say about hyperbaric chamber, that did help my back initially, but then it quit making a difference.

Benefits wise for me:
Pentosan 4/10
Placental MCS Exosomes 9/10.

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#20

Thanks for your insights. I may try synovial fluid first.