fbpx
Wikipedia

Pentosan polysulfate

September 02, 2023

Pentosan polysulfate, sold under the brand name Elmiron among others, is a medication used for the treatment of interstitial cystitis.[1] It was approved for medical use in the United States in 1996.[1][2][3]

Pentosan polysulfate
Clinical data
Trade namesElmiron, Zycosan
Other namesPPS, (1->4)-β-Xylan 2,3-bis(hydrogen sulfate) with a 4 O-methyl-α-D-glucuronate
AHFS/Drugs.comMonograph
License data
Routes of
administration		By mouth, intramuscular
ATC code
Legal status
Legal status
Pharmacokinetic data
ExcretionFeces, urine[1]
Identifiers
CAS Number
  • 37300-21-3 Y
  • as sodium: 140207-93-8
PubChem CID
  • 37720
DrugBank
  • DB00686
ChemSpider
  • 34595 Y
UNII
  • F59P8B75R4
  • as sodium: 914032762Y
KEGG
  • as sodium: D05428
ChEMBL
  • ChEMBL4073796
  • as sodium: ChEMBL1201516
CompTox Dashboard (EPA)
  • DTXSID10190764
Chemical and physical data
FormulaC10H18O21S4
Molar mass602.47 g·mol−1
3D model (JSmol)
  • Interactive image
  • O[C@@H]1CO[C@@H](O[C@@H]2CO[C@@H](O)[C@H](OS(O)(=O)=O)[C@H]2OS(O)(=O)=O)[C@H](OS(O)(=O)=O)[C@H]1OS(O)(=O)=O
  • InChI=1S/C10H18O21S4/c11-3-1-26-10(8(31-35(22,23)24)5(3)28-32(13,14)15)27-4-2-25-9(12)7(30-34(19,20)21)6(4)29-33(16,17)18/h3-12H,1-2H2,(H,13,14,15)(H,16,17,18)(H,19,20,21)(H,22,23,24)/t3-,4-,5+,6+,7-,8-,9-,10+/m1/s1
  • Key:FCCNSUIJIOOXEZ-SJYYZXOBSA-N
  (verify)

Medical uses Edit

Pentosan polysulfate sodium is indicated for the relief of bladder pain or discomfort associated with interstitial cystitis.[1]

Adverse effects Edit

Patients who have taken pentosan polysulfate orally report a variety of side effects, primarily gastrointestinal complaints such as diarrhea, heartburn, and stomach pain.[4] Hair loss, headache, rash, and insomnia have also been reported.[4] Due to Elmiron's anticoagulant effects, some patients report bruising more easily. In some cases, patients are asked to stop taking the medication before any major surgical procedures to reduce the likelihood of bleeding. Recent report based on clinical observation hypothesizes that chronic exposure to pentosan polysulfate can cause retinal toxicity, mimicking pigmentary pattern dystrophy.[2][5][6][7]

Mechanism of action Edit

In interstitial cystitis, pentosan polysulfate is believed to work by providing a protective coating to the damaged bladder wall. Pentosan polysulfate is similar in structure to the natural glycosaminoglycan coating of the inner lining of the bladder, and may replace or repair the lining, reducing its permeability.[5]

History Edit

The calcium salt of pentosan polysulfate was one of the first reported disease-modifying osteoarthritis drugs (DMOAD).[6]

Society and culture Edit

Names Edit

The IUPAC name for pentosan polysulfate is [(2R,3R,4S,5R)-2-hydroxy-5-[(2S,3R,4S,5R)-5-hydroxy-3,4-disulfooxyoxan-2-yl]oxy-3-sulfooxyoxan-4-yl] hydrogen sulfate.[8]

There are 40 synonyms listed for pentosan polysulfate on PubChem including BAY-946, HOE-946, pentosan sulfuric polyester, polypentose sulfate, polysulfated xylan, PZ-68, SP-54, xylan SP54 and xylan sulfate.[9]

Various brand names include Elmiron (as sodium salt), Hemoclar, Anarthron, Fibrase, Fibrocid, Thrombocid and SP54. Pentosan polysulfate capsules are sold in India under the brand names Comfora, Pentossan-100, Cystopen and For-IC. In the veterinary field, pentosan polysulfate is sold as Cartrophen Vet and Sylvet by Biopharm Australia, Pentosan by Naturevet Australia, Anarthron by Randlab Australia and Zydax by Parnell.[10]

Research Edit

Osteoarthritis Edit

Pentosan polysulfate has been studied in knee osteoarthritis, though evidence to support such use is poor as of 2003.[11] There is some theoretical evidence that it should help.[12]

Transmissible spongiform encephalopathies Edit

Pentosan polysulfate is being studied as a potential treatment of Creutzfeldt–Jakob disease (CJD). The rationale for this treatment was unclear but it was subsequently shown in prion-infected mouse neuroblastoma cells that pentosan polysulfate could rapidly reduce the levels of abnormal (scrapie) prion without affecting the normal cellular isoform.[13] As pentosan polysulfate can bind to the cellular isoform of the prion protein, it may stabilise this form and prevent its conversion to the pathological (scrapie) isoform.[14]

The treatment[15] of one patient in Northern Ireland and around six other patients in mainland Britain was reported in the press.[16]

Veterinary uses Edit

Dogs Edit

Read et al. (1996) [17] used three different doses of sodium pentosan polysulfate to treat 40 geriatric dogs with well-established clinical signs of chronic osteoarthritis (OA) with a subcutaneous injection. The 3 mg/kg dose was the most effective. In a study conducted with 10 elderly dogs with osteoarthritis given calcium pentosan polysulfate (3 mg/kg intramuscularly) once weekly for four weeks, the improvement in symptoms (seen at 1, 2, 3 and 7 weeks after initiation of therapy) was found to correlate with plasma indices of fibrinolytic activity and lipid profiles.[18] In a study in dogs with OA secondary to cranial cruciate ligament deficiency, although no differences were identified in either functional outcome or radiographic progression using the oral calcium pentosan polysulfate compared with placebo, there were significantly lower levels of proteoglycan breakdown products in the synovial fluid of the osteoarthritic joints.[19] The efficacy of subcutaneous sodium pentosan polysulfate (3 mg/kg) was tested in 40 dogs with cranial cruciate ligament instability and found to hasten recovery, as measured by more rapidly improved ground reaction forces, over 48 weeks.[20]

Horses Edit

Zycosan, for horses, is a heparin-like compound and is the first injectable pentosan product to receive approval by the US Food and Drug Administration (FDA).[21]

In December 2022, the US Food and Drug Administration (FDA) approved pentosan polysulfate (Zycosan) for the control of clinical signs associated with osteoarthritis in horses.[21] Zycosan is for intramuscular use in horses only and is not for use in humans.[21] Zycosan is sponsored by Anzac Animal Health LLC, based in Maryland Heights, Missouri.[21]

Pentosan polysulfate is being used for this osteoarthritis in Australia. When administered to racing thoroughbreds with chronic osteoarthritis (2 to 3 mg/kg, intramuscularly, once weekly for 4 weeks, then as required), pentosan polysulfate treatment improved but did not eliminate clinical signs of joint disease.[22] Articular cartilage fibrillation was substantially reduced by similar NaPPS treatment intramuscularly in nine horses with experimentally-induced carpal osteoarthritis.[23]

References Edit

  1. ^ a b c d e "Elmiron- pentosan polysulfate sodium capsule, gelatin coated". DailyMed. 10 November 2022. Retrieved 21 December 2022.
  2. ^ a b Lindeke-Myers A, Hanif AM, Jain N (2022). "Pentosan polysulfate maculopathy". Survey of Ophthalmology. 67 (1): 83–96. doi:10.1016/j.survophthal.2021.05.005. PMID 34000253. S2CID 234767956.
  3. ^ https://www.accessdata.fda.gov/drugsatfda_docs/nda/pre96/020193Orig1s000rev.pdf[bare URL PDF]
  4. ^ a b Pubmed Health (2012). "Pentosan Polysulfate". U.S. National Library of Medicine. Retrieved 2 October 2012.
  5. ^ a b Parsons CL (1994). "The therapeutic role of sulfated polysaccharides in the urinary bladder". Urol Clin North Am. 21 (1): 93–100. doi:10.1016/S0094-0143(21)00597-8. PMID 7904388.
  6. ^ a b Ghosh, P; Smith, M (2002). "Osteoarthritis, genetic and molecular mechanisms". Biogerontology. 3 (1–2): 85–8. doi:10.1023/a:1015219716583. PMID 12014849. S2CID 33755966.
  7. ^ Hanif AM, Armenti ST, Taylor SC, Shah RA, Igelman AD, Jayasundera KT, et al. (November 2019). "Phenotypic Spectrum of Pentosan Polysulfate Sodium-Associated Maculopathy: A Multicenter Study". JAMA Ophthalmology. 137 (11): 1275–1282. doi:10.1001/jamaophthalmol.2019.3392. PMC 6735406. PMID 31486843.
  8. ^ PubChem. "Pentosan polysulfate". pubchem.ncbi.nlm.nih.gov. Retrieved 8 November 2022.
  9. ^ PubChem. "Pentosan polysulfate". pubchem.ncbi.nlm.nih.gov. Retrieved 8 November 2022.
  10. ^ Hannon, R. L.; Smith, J. G.; Cullis-Hill, D.; Ghosh, P.; Cawdery, M. J. Hope (2003). "Safety of Cartrophen Vet in the dog: review of adverse reaction reports in the UK". The Journal of Small Animal Practice. 44 (5): 202–208. doi:10.1111/j.1748-5827.2003.tb00144.x. ISSN 0022-4510. PMID 12779171.
  11. ^ Uthman I, Raynauld JP, Haraoui B (August 2003). "Intra-articular therapy in osteoarthritis". Postgraduate Medical Journal. 79 (934): 449–53. doi:10.1136/pmj.79.934.449. PMC 1742771. PMID 12954956.
  12. ^ Ghosh, P (1999). "The pathobiology of osteoarthritis and the rationale for the use of pentosan polysulfate for its treatment". Semin Arthritis Rheum. 28 (4): 211–67. doi:10.1016/s0049-0172(99)80021-3. PMID 10073500.
  13. ^ Yamasaki, Takeshi; Suzuki, Akio; Hasebe, Rie; Horiuchi, Motohiro (2014). "Comparison of the Anti-Prion Mechanism of Four Different Anti-Prion Compounds, Anti-PrP Monoclonal Antibody 44B1, Pentosan Polysulfate, Chlorpromazine, and U18666A, in Prion-Infected Mouse Neuroblastoma Cells". PLOS ONE. 9 (9): e106516. Bibcode:2014PLoSO...9j6516Y. doi:10.1371/journal.pone.0106516. PMC 4152300. PMID 25181483.
  14. ^ Kamatari, Yuji O; Hayano, Yosake; Yamaguchi, Kei-ichi; Hosokawa-Muto, Junji; Kuwata, Kazuo (2012). "Characterizing antiprion compounds based on their binding properties to prion proteins: Implications as medical chaperones". Protein Sci. 22 (1): 22–34. doi:10.1002/pro.2180. PMC 3575857. PMID 23081827.
  15. ^ Whittle, IR; Knight, RS; Will, RG (2006). "Unsuccessful intraventricular pentosan polysulphate treatment of variant Creutzfeldt–Jakob disease". Acta Neurochir (Wien). 148 (6): 677–679. doi:10.1007/s00701-006-0772-y. PMID 16598408. S2CID 37400744.
  16. ^ "Research will now assess CJD drug". 1 March 2005 – via news.bbc.co.uk.
  17. ^ Read, RA; Cullis-Hill, D; Jones, MP (1996). "Systemic use of pentosan polysulphate in the treatment of osteoarthritis". J Small Anim Pract. 37 (3): 108–114. doi:10.1111/j.1748-5827.1996.tb02355.x. PMID 8683953.
  18. ^ Ghosh, P; Cheras, PA (2001). "Vascular mechanisms in osteoarthritis". Best Pract Res Clin Rheumatol. 15 (5): 693–709. doi:10.1053/berh.2001.0188. PMID 11812016.
  19. ^ Innes, JF; Barr, AR; Sharif, M (2000). "Efficacy of oral calcium pentosan polysulphate for the treatment of osteoarthritis of the canine stifle joint secondary to cranial cruciate ligament deficiency". Vet Rec. 146 (15): 433–437. doi:10.1136/vr.146.15.433. PMID 10811265. S2CID 46623547.
  20. ^ Budsberg, SC; Bergh, MS; Reynolds, LR; Streppa, HK (2007). "Evaluation of pentosan polysulfate sodium in the postoperative recovery from cranial cruciate injury in dogs: a randomized, placebo-controlled clinical trial". Vet Surg. 36 (3): 234–244. doi:10.1111/j.1532-950x.2007.00256.x. PMID 17461948.
  21. ^ a b c d "FDA Approves First Injectable Pentosan for Osteoarthritis in Horses". U.S. Food and Drug Administration (FDA). 20 December 2022. Retrieved 21 December 2022.   This article incorporates text from this source, which is in the public domain.
  22. ^ Little, CB; Ghosh, P (1996). McIlwraith, CW; Trotter, GW (eds.). Joint Disease in the Horse. Philadelphia: WB Saunders Company. pp. 281–292.
  23. ^ McIlwraith, CW; Frisbie, DD; Kawcak, CE (2012). "Evaluation of intramuscularly administered sodium pentosan polysulfate for treatment of experimentally induced osteoarthritis in horses". Am J Vet Res. 73 (5): 628–633. doi:10.2460/ajvr.73.5.628. PMID 22533393.

September 02, 2023
pentosan, polysulfate, sold, under, brand, name, elmiron, among, others, medication, used, treatment, interstitial, cystitis, approved, medical, united, states, 1996, clinical, datatrade, nameselmiron, zycosanother, namespps, xylan, hydrogen, sulfate, with, me. Pentosan polysulfate sold under the brand name Elmiron among others is a medication used for the treatment of interstitial cystitis 1 It was approved for medical use in the United States in 1996 1 2 3 Pentosan polysulfateClinical dataTrade namesElmiron ZycosanOther namesPPS 1 gt 4 b Xylan 2 3 bis hydrogen sulfate with a 4 O methyl a D glucuronateAHFS Drugs comMonographLicense dataUS DailyMed pentosan polysulfateRoutes ofadministrationBy mouth intramuscularATC codeC05BA04 WHO G04BX15 WHO QC05BA04 WHO QG04BX15 WHO QM01AX90 WHO Legal statusLegal statusUS only 1 Pharmacokinetic dataExcretionFeces urine 1 IdentifiersCAS Number37300 21 3 Yas sodium 140207 93 8PubChem CID37720DrugBankDB00686ChemSpider34595 YUNIIF59P8B75R4as sodium 914032762YKEGGas sodium D05428ChEMBLChEMBL4073796as sodium ChEMBL1201516CompTox Dashboard EPA DTXSID10190764Chemical and physical dataFormulaC 10H 18O 21S 4Molar mass602 47 g mol 13D model JSmol Interactive imageSMILES O C H 1CO C H O C H 2CO C H O C H OS O O O C H 2OS O O O C H OS O O O C H 1OS O O OInChI InChI 1S C10H18O21S4 c11 3 1 26 10 8 31 35 22 23 24 5 3 28 32 13 14 15 27 4 2 25 9 12 7 30 34 19 20 21 6 4 29 33 16 17 18 h3 12H 1 2H2 H 13 14 15 H 16 17 18 H 19 20 21 H 22 23 24 t3 4 5 6 7 8 9 10 m1 s1Key FCCNSUIJIOOXEZ SJYYZXOBSA N verify Contents 1 Medical uses 2 Adverse effects 3 Mechanism of action 4 History 5 Society and culture 5 1 Names 6 Research 6 1 Osteoarthritis 6 2 Transmissible spongiform encephalopathies 7 Veterinary uses 7 1 Dogs 7 2 Horses 8 ReferencesMedical uses EditPentosan polysulfate sodium is indicated for the relief of bladder pain or discomfort associated with interstitial cystitis 1 Adverse effects EditPatients who have taken pentosan polysulfate orally report a variety of side effects primarily gastrointestinal complaints such as diarrhea heartburn and stomach pain 4 Hair loss headache rash and insomnia have also been reported 4 Due to Elmiron s anticoagulant effects some patients report bruising more easily In some cases patients are asked to stop taking the medication before any major surgical procedures to reduce the likelihood of bleeding Recent report based on clinical observation hypothesizes that chronic exposure to pentosan polysulfate can cause retinal toxicity mimicking pigmentary pattern dystrophy 2 5 6 7 Mechanism of action EditIn interstitial cystitis pentosan polysulfate is believed to work by providing a protective coating to the damaged bladder wall Pentosan polysulfate is similar in structure to the natural glycosaminoglycan coating of the inner lining of the bladder and may replace or repair the lining reducing its permeability 5 History EditThe calcium salt of pentosan polysulfate was one of the first reported disease modifying osteoarthritis drugs DMOAD 6 Society and culture EditNames Edit The IUPAC name for pentosan polysulfate is 2R 3R 4S 5R 2 hydroxy 5 2S 3R 4S 5R 5 hydroxy 3 4 disulfooxyoxan 2 yl oxy 3 sulfooxyoxan 4 yl hydrogen sulfate 8 There are 40 synonyms listed for pentosan polysulfate on PubChem including BAY 946 HOE 946 pentosan sulfuric polyester polypentose sulfate polysulfated xylan PZ 68 SP 54 xylan SP54 and xylan sulfate 9 Various brand names include Elmiron as sodium salt Hemoclar Anarthron Fibrase Fibrocid Thrombocid and SP54 Pentosan polysulfate capsules are sold in India under the brand names Comfora Pentossan 100 Cystopen and For IC In the veterinary field pentosan polysulfate is sold as Cartrophen Vet and Sylvet by Biopharm Australia Pentosan by Naturevet Australia Anarthron by Randlab Australia and Zydax by Parnell 10 Research EditOsteoarthritis Edit Pentosan polysulfate has been studied in knee osteoarthritis though evidence to support such use is poor as of 2003 11 There is some theoretical evidence that it should help 12 Transmissible spongiform encephalopathies Edit Pentosan polysulfate is being studied as a potential treatment of Creutzfeldt Jakob disease CJD The rationale for this treatment was unclear but it was subsequently shown in prion infected mouse neuroblastoma cells that pentosan polysulfate could rapidly reduce the levels of abnormal scrapie prion without affecting the normal cellular isoform 13 As pentosan polysulfate can bind to the cellular isoform of the prion protein it may stabilise this form and prevent its conversion to the pathological scrapie isoform 14 The treatment 15 of one patient in Northern Ireland and around six other patients in mainland Britain was reported in the press 16 Veterinary uses EditDogs Edit Read et al 1996 17 used three different doses of sodium pentosan polysulfate to treat 40 geriatric dogs with well established clinical signs of chronic osteoarthritis OA with a subcutaneous injection The 3 mg kg dose was the most effective In a study conducted with 10 elderly dogs with osteoarthritis given calcium pentosan polysulfate 3 mg kg intramuscularly once weekly for four weeks the improvement in symptoms seen at 1 2 3 and 7 weeks after initiation of therapy was found to correlate with plasma indices of fibrinolytic activity and lipid profiles 18 In a study in dogs with OA secondary to cranial cruciate ligament deficiency although no differences were identified in either functional outcome or radiographic progression using the oral calcium pentosan polysulfate compared with placebo there were significantly lower levels of proteoglycan breakdown products in the synovial fluid of the osteoarthritic joints 19 The efficacy of subcutaneous sodium pentosan polysulfate 3 mg kg was tested in 40 dogs with cranial cruciate ligament instability and found to hasten recovery as measured by more rapidly improved ground reaction forces over 48 weeks 20 Horses Edit Zycosan for horses is a heparin like compound and is the first injectable pentosan product to receive approval by the US Food and Drug Administration FDA 21 In December 2022 the US Food and Drug Administration FDA approved pentosan polysulfate Zycosan for the control of clinical signs associated with osteoarthritis in horses 21 Zycosan is for intramuscular use in horses only and is not for use in humans 21 Zycosan is sponsored by Anzac Animal Health LLC based in Maryland Heights Missouri 21 Pentosan polysulfate is being used for this osteoarthritis in Australia When administered to racing thoroughbreds with chronic osteoarthritis 2 to 3 mg kg intramuscularly once weekly for 4 weeks then as required pentosan polysulfate treatment improved but did not eliminate clinical signs of joint disease 22 Articular cartilage fibrillation was substantially reduced by similar NaPPS treatment intramuscularly in nine horses with experimentally induced carpal osteoarthritis 23 References Edit a b c d e Elmiron pentosan polysulfate sodium capsule gelatin coated DailyMed 10 November 2022 Retrieved 21 December 2022 a b Lindeke Myers A Hanif AM Jain N 2022 Pentosan polysulfate maculopathy Survey of Ophthalmology 67 1 83 96 doi 10 1016 j survophthal 2021 05 005 PMID 34000253 S2CID 234767956 https www accessdata fda gov drugsatfda docs nda pre96 020193Orig1s000rev pdf bare URL PDF a b Pubmed Health 2012 Pentosan Polysulfate U S National Library of Medicine Retrieved 2 October 2012 a b Parsons CL 1994 The therapeutic role of sulfated polysaccharides in the urinary bladder Urol Clin North Am 21 1 93 100 doi 10 1016 S0094 0143 21 00597 8 PMID 7904388 a b Ghosh P Smith M 2002 Osteoarthritis genetic and molecular mechanisms Biogerontology 3 1 2 85 8 doi 10 1023 a 1015219716583 PMID 12014849 S2CID 33755966 Hanif AM Armenti ST Taylor SC Shah RA Igelman AD Jayasundera KT et al November 2019 Phenotypic Spectrum of Pentosan Polysulfate Sodium Associated Maculopathy A Multicenter Study JAMA Ophthalmology 137 11 1275 1282 doi 10 1001 jamaophthalmol 2019 3392 PMC 6735406 PMID 31486843 PubChem Pentosan polysulfate pubchem ncbi nlm nih gov Retrieved 8 November 2022 PubChem Pentosan polysulfate pubchem ncbi nlm nih gov Retrieved 8 November 2022 Hannon R L Smith J G Cullis Hill D Ghosh P Cawdery M J Hope 2003 Safety of Cartrophen Vet in the dog review of adverse reaction reports in the UK The Journal of Small Animal Practice 44 5 202 208 doi 10 1111 j 1748 5827 2003 tb00144 x ISSN 0022 4510 PMID 12779171 Uthman I Raynauld JP Haraoui B August 2003 Intra articular therapy in osteoarthritis Postgraduate Medical Journal 79 934 449 53 doi 10 1136 pmj 79 934 449 PMC 1742771 PMID 12954956 Ghosh P 1999 The pathobiology of osteoarthritis and the rationale for the use of pentosan polysulfate for its treatment Semin Arthritis Rheum 28 4 211 67 doi 10 1016 s0049 0172 99 80021 3 PMID 10073500 Yamasaki Takeshi Suzuki Akio Hasebe Rie Horiuchi Motohiro 2014 Comparison of the Anti Prion Mechanism of Four Different Anti Prion Compounds Anti PrP Monoclonal Antibody 44B1 Pentosan Polysulfate Chlorpromazine and U18666A in Prion Infected Mouse Neuroblastoma Cells PLOS ONE 9 9 e106516 Bibcode 2014PLoSO 9j6516Y doi 10 1371 journal pone 0106516 PMC 4152300 PMID 25181483 Kamatari Yuji O Hayano Yosake Yamaguchi Kei ichi Hosokawa Muto Junji Kuwata Kazuo 2012 Characterizing antiprion compounds based on their binding properties to prion proteins Implications as medical chaperones Protein Sci 22 1 22 34 doi 10 1002 pro 2180 PMC 3575857 PMID 23081827 Whittle IR Knight RS Will RG 2006 Unsuccessful intraventricular pentosan polysulphate treatment of variant Creutzfeldt Jakob disease Acta Neurochir Wien 148 6 677 679 doi 10 1007 s00701 006 0772 y PMID 16598408 S2CID 37400744 Research will now assess CJD drug 1 March 2005 via news bbc co uk Read RA Cullis Hill D Jones MP 1996 Systemic use of pentosan polysulphate in the treatment of osteoarthritis J Small Anim Pract 37 3 108 114 doi 10 1111 j 1748 5827 1996 tb02355 x PMID 8683953 Ghosh P Cheras PA 2001 Vascular mechanisms in osteoarthritis Best Pract Res Clin Rheumatol 15 5 693 709 doi 10 1053 berh 2001 0188 PMID 11812016 Innes JF Barr AR Sharif M 2000 Efficacy of oral calcium pentosan polysulphate for the treatment of osteoarthritis of the canine stifle joint secondary to cranial cruciate ligament deficiency Vet Rec 146 15 433 437 doi 10 1136 vr 146 15 433 PMID 10811265 S2CID 46623547 Budsberg SC Bergh MS Reynolds LR Streppa HK 2007 Evaluation of pentosan polysulfate sodium in the postoperative recovery from cranial cruciate injury in dogs a randomized placebo controlled clinical trial Vet Surg 36 3 234 244 doi 10 1111 j 1532 950x 2007 00256 x PMID 17461948 a b c d FDA Approves First Injectable Pentosan for Osteoarthritis in Horses U S Food and Drug Administration FDA 20 December 2022 Retrieved 21 December 2022 nbsp This article incorporates text from this source which is in the public domain Little CB Ghosh P 1996 McIlwraith CW Trotter GW eds Joint Disease in the Horse Philadelphia WB Saunders Company pp 281 292 McIlwraith CW Frisbie DD Kawcak CE 2012 Evaluation of intramuscularly administered sodium pentosan polysulfate for treatment of experimentally induced osteoarthritis in horses Am J Vet Res 73 5 628 633 doi 10 2460 ajvr 73 5 628 PMID 22533393 Portal nbsp Medicine Retrieved from https en wikipedia org w index php title Pentosan polysulfate amp oldid 1170127939, wikipedia, wiki, book, books, library,

article

, read, download, free, free download, mp3, video, mp4, 3gp, jpg, jpeg, gif, png, picture, music, song, movie, book, game, games.