Cetylated fatty acids (CFAs)

CFAs are nutritional supplements. You can buy them over the counter in pharmacies and health food shops. There’s a little evidence that the cream may be effective in improving some aspects of range of motion in the knees of participants with osteoarthritis. How it works, its safety and its effectiveness in relation to conventional medications is still unclear.

• Family: Nutritional supplement
• Scientific name: Cetylated fatty acids
• Other names: Individual CFAs (for example cetyl myristoleate), combinations of CFAs (for example Celadrin®)

Cetyl myristoleate (a specific CFA) was proposed as a possible treatment for musculoskeletal conditions in the 1970s by an American chemist who found that it might be responsible for protecting mice against the development of rheumatoid arthritis. You can buy CFA capsules (350 mg) and creams in pharmacies and health food shops.

The exact ways that CFAs work in treating musculoskeletal conditions haven’t been formally studied. It’s been proposed that they may have a lubricant effect on joints. They may improve your body’s production of prostaglandins (hormone-like substances that regulate your immune system and fight joint inflammation).

No serious side-effects have been reported and interactions with other medications haven’t been examined. The best dose hasn’t been found, but a treatment plan consisting of three capsules of Celadrin® containing 350 mg of CFAs per day has been used in studies.

Two RCTs evaluated the role of CFAs in treating osteoarthritis of the knee. In both trials, the medication was well tolerated with no serious side-effects.

Trial 1‡

In the first trial, 64 participants were randomly assigned to receive either active capsules (350 mg of CFAs) or placebo capsules six times a day for 68 days. Participants were asked to continue taking their regular medication during the trial.

• Neither group reported improvement in knee extension.
• Participants in the active treatment group had significantly increased knee flexion.

Trial 2‡

Participants in the second trial were randomly selected to receive either CFA cream or a placebo cream. All 40 participants were asked to apply the cream to their knee twice a day for 30 days.

• Those in the active treatment group experienced significant improvement in climbing stairs and standing up from a sitting position.
• The overall range of motion of the knee was markedly improved in participants who used CFA cream.

‡ A trial of low quality. Results of this trial were given a lower weighting when we came to our conclusion about the compound.