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The properties of PPS were first investigated in sheep, dogs, rabbits, rats and chickens. Researchers noted a beneficial effect in cases of osteoarthritis in dogs, and sodium PPS was first approved as an injectable canine arthritis treatment in 1986 in Australia. It was next approved for the treatment of canine arthritis in New Zealand, the United Kingdom, Canada and Ireland. Since some of the initial studies also focused on use in people, PPS next gained approval as a human joint treatment throughout most of the European community, Scandinavia, South Africa and Australia.
When eleven women with knee or hip OA were injected with 3 mg/kg NaPPS, both hepatolipases and lipoprotein lipases were significantly elevated in their plasma for at least eight hours but had returned to normal levels by 24 hours.  A double blind, placebo-controlled clinical study in 114 patients with osteoarthritis of the knee was performed in Perth, Australia where patients either received a salt solution or sodium PPS at 3 mg/ kg as an intramuscular injection once weekly for 4 weeks.  Overall, NaPPS treatment significantly improved the duration of joint stiffness and pain at rest compared with controls for 20 weeks after the cessation of treatment, and significantly improved pain on walking and overall function for 8 weeks after the cessation of treatment. Twenty patients with knee OA were assessed clinically at Nagasaki University Hospital in a single-center, open-label trial. Treatment consisted of 6 weekly subcutaneous injections of pentosan (2 mg/kg). Knee flexion, pain while walking, pain after climbing up and down stairs were improved significantly for up to a year.