Topical cetylated fatty acid cream improves mobility in OA knee

[Guest guest]

Rheumawire

Apr 8, 2004

Topical cetylated fatty acid cream improves mobility in OA knee

Storrs, CT - A topical cream containing cetylated fatty acids (CFA) was

significantly better than a placebo cream at improving knee range of

motion, ability to rise from a chair, stair-climbing ability, and

unilateral balance in patients with knee osteoarthritis (OA) in work

reported by Dr J Kraemer (University of Connecticut School of

Medicine, Storrs) and associates in the April 2004 issue of the Journal

of Rheumatology [1]. This study has been widely discussed in arthritis

patient support groups and internet lists and is expected to generate

considerable interest among OA patients.

" This was an effective adjunctive therapy and helped in functional

movement capabilities, " Kraemer tells rheumawire.

The trial, which was supported by Imagenetix Inc (San Diego, CA),

randomized 40 patients with knee OA either to a topical cream containing

CFA (CeladrinTM, Imagenetix) or to the same cream without CFA. The blend

of CFA included cetyl myristoleate, cetyl myristate, cetyl palmitoleate,

cetyl laureate, cetyl palmitate, and cetyl oleate. Patients applied a

standardized amount of cream to the anterior, posterior, and lateral

aspects of both knees over a 10-to-12-cm area twice per day for 30 days.

The protocol also included careful nutrition and activity monitoring to

ensure that any changes observed would not be the result of weight

change or changes in activity level.

Primary outcome measures were the timed up-and-go test, timed stair

climbing, timed stair descending, unilateral anterior reach (a measure

of balance and endurance), medial step-down test, and knee range of

motion. Kraemer reports that in all outcome measures, the patients

treated with CFA cream improved significantly more than those who

received placebo.

The investigators report, " The most remarkable finding was that

stair-climbing ability improved immediately after 30 min of initial

treatment. These data suggest that the rapid improvement observed in

ascending/descending stair times may have been due to immediate pain

relief and reduced stiffness. In addition, further improvement was

observed after 30 days of treatment, revealing a chronic effect of CFA

topical treatment. "

" It was exciting to see the positive effects on function. Effects

appeared acutely and were maintained over the entire treatment period,

but future studies will be needed to assess durability of response, "

Kraemer says.

The mechanism of action of topical CFA is unknown, but the researchers

speculate that it involves reduction of chronic inflammation, since

fatty acids have been shown to reduce leukotriene B4 from stimulated

neutrophils and interleukin 1 from monocytes in RA patients. Kraemer

says that cetylated monounsaturated fatty acids have also been shown to

protect rats against experimental arthritis. " We have no data regarding

the absorption of the CFA cream through the skin and into the joint, but

such studies should be a topic of further investigation of the mediating

mechanisms, " Kraemer writes.

No side effects were observed, which is fortunate, since CFA creams are

readily available via the internet at a price of $12.95 per 2-ounce jar.

Janis

Source

1. Kraemer WJ, Ratamess NA, JM, et al. Effect of a cetylated

fatty acid topical cream on functional mobility and quality of life of

patients with osteoarthritis. J Rheumatol 2004; 31:767-774.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org