Efficacy and safety of pentosan polysulfate sodium in people with symptomatic knee osteoarthritis and dyslipidaemia: protocol of the MaRVeL trial

BMJ Open. 2024 May 22;14(5):e083046. doi: 10.1136/bmjopen-2023-083046.

Abstract

Introduction: Knee osteoarthritis (OA) is the most prevalent arthritis type and a leading cause of chronic mobility disability. While pain medications provide only symptomatic pain relief; growing evidence suggests pentosan polysulfate sodium (PPS) is chondroprotective and could have anti-inflammatory effects in knee OA. This study aims to explore the efficacy and safety of oral PPS in symptomatic knee OA with dyslipidaemia.

Methods and analysis: MaRVeL is a phase II, single-centre, parallel, superiority trial which will be conducted at Royal North Shore Hospital, Sydney, Australia. 92 participants (46 per arm) aged 40 and over with painful knee OA and mild to moderate structural change on X-ray (Kellgren and Lawrence grade 2 or 3) will be recruited from the community and randomly allocated to receive two cycles of either oral PPS or placebo for 5 weeks starting at baseline and week 11. Primary outcome will be the 16-week change in overall average knee pain severity measured using an 11-point Numeric Rating Scale. Main secondary outcomes include change in knee pain, patient global assessment, physical function, quality of life and other structural changes. A biostatistician blinded to allocation groups will perform the statistical analysis according to the intention-to-treat principle.

Ethics and dissemination: The protocol has been approved by the NSLHD Human Research Ethics Committee (HREC) (2021/ETH00315). All participants will provide written informed consent online. Study results will be disseminated through conferences, social media and academic publications.

Trial registration numbers: Australian New Zealand Clinical Trial Registry (ACTRN12621000654853); U1111-1265-3750.

Keywords: Clinical Trial; Knee; Osteoarthritis; PAIN MANAGEMENT; Phase II as Topic.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Adult
  • Australia
  • Clinical Trials, Phase II as Topic
  • Dyslipidemias* / complications
  • Dyslipidemias* / drug therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis, Knee* / drug therapy
  • Pain Measurement
  • Pentosan Sulfuric Polyester* / administration & dosage
  • Pentosan Sulfuric Polyester* / therapeutic use
  • Quality of Life
  • Treatment Outcome

Substances

  • Pentosan Sulfuric Polyester