Cetylated Fatty Acids

BACKGROUND/OBJECTIVES: The development and implementation of new treatments for knee osteoarthritis in routine practice remains an unmet need. The aim of this study was to assess the efficacy and safety of a Cetylated Fatty Acids (CFA)-based dietary supplement in patients with knee osteoarthritis (OA), a prevalent and difficult-to-treat condition. SUBJECTS/METHODS: 60 patients (mean age: 66.0 ± 7.7 years, 85% female) with grade 3-4 knee osteoarthritis and a pain intensity of > 4 cm on the visual analog scale (VAS) were enrolled and randomized in a 1:1 ratio to receive either 1.5 g of oral CFA or a placebo for 60 days. The primary outcome was the change in pain intensity (VAS), secondary outcomes included changes in range of motion (ROM), in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the safety profile of the food supplement. RESULTS: After 60 days of CFA assumption, the mean reduction in pain intensity (VAS) was -1.7 cm (95% CI [-2.0, -1.4]), showing a statistically significant difference compared to placebo (-0.6 cm, 95% CI [-1.0, -0.2]; p < 0.005). The mean decrease in the WOMAC total score was also greater in the CFA group (-19.5 vs. -15.8), although the placebo-corrected effect was not statistically significant (-3.7, 95% CI [-8.3, 0.8]; p = 0.108). Observed improvements in flexion (3.8° [95% CI: 2.6, 5.0]) and external rotation (2.9° [95% CI: 2.1, 3.8]) were both statistically significant in favor of CFA (p ≤ 0.001) compared to placebo. Differences in extension and internal rotation were negligible. The safety profile of the investigational product resulted favorable, considering that only 4 out of 30 patients reported mild adverse events, and none withdrawn from the study due to adverse events. CONCLUSION: In patients with knee osteoarthritis, incorporating a CFA oral supplement into the treatment regimen provides superior efficacy in pain relief and range of motion improvement compared to placebo, while maintaining a favorable safety profile. © 2025. The Author(s).

In addition to topical non-steroidal anti-inflammatory drugs that are used in hand osteoarthritis, there are other drugs that can reduce pain in osteoarthritis, such as topical cetylated fatty acids. Previous studies have reported that topical CFAs are effective in all knee OA patients, with slightly higher evidence for those with advanced disease. The mechanism of pain in OA knee and OA hand is similar. Furthermore, there are no previous studies on CFAs in OA hand. Patients fulfilling the American College of Rheumatology criteria for hand OA participated in this randomized, double-blind, placebo-controlled study. Eligible patients were over 40 years of age, had at least one tender joint, and had a joint pain visual analog score of 30-60 mm. Patients received topical CFA (n = 36) or placebo (n = 36) twice daily for six weeks. The primary outcome was the Functional Index for Hand Osteoarthritis (FIHOA) at 2, 4, and 6 weeks. The secondary outcome measures included the Visual Analog Score (VAS), Patient Global Assessment (PGA), and skin irritation at 2, 4, and 6 weeks. At baseline, no statistically significant differences were observed among the assessment parameters. Upon concluding the 6-week study period, it was evident that patients in the CFA group exhibited a notably lower mean pain score compared to those in the placebo group (2.2 ± 1.9 vs. 3.2 ± 2.2, P < 0.05) and achieved superior PGA scores (2.1 ± 1.7 vs. 3.1 ± 2.2, P < 0.05). However, no significant disparity was detected in terms of FIHOA between the two groups. Additionally, adverse reactions were reported by two patients in the placebo group, whereas no such reports were documented in the CFA group. Topical CFAs demonstrate efficacy in alleviating pain and enhancing patient global satisfaction in the treatment of hand osteoarthritis. However, a more extended follow-up period is imperative to ascertain whether disparities exist in the safety profile and functional outcomes between topical CFAs and a placebo. © 2025. The Author(s).

OBJECTIVES: Knee osteoarthritis (OA) continues to be a debilitating global health issue, with effective treatments that have minimal side effects still lacking in modern clinical practice. Cetylated fatty acids (CFAs), a group of esterified fatty acids administered either topically or orally to protect the synovial membrane and stabilise cell membranes, appears to be a promising therapeutic option. METHODS: We conducted a comprehensive search in PubMed, Embase, Cochrane Library, CENTRAL, and Web of Science from the inception until November 2024 to examine the therapeutic effects of CFAs. We included randomised controlled trials (RCTs) with a CFA intervention group compared with a control group that received either a placebo or a non-CFA treatment, as well as pre-post experimental studies that investigate pre-treatment and post-treatment CFA interventions. Subgroup analyses for different forms of CFAs were also conducted. RESULTS: A total of 5 RCTs and 2 pre-post experimental studies with 357 participants were included. Significant improvements were observed in pain levels (SMD= -0.37, 95% CI= -0.60 to -0.15, p=0.0009), knee ROM (SMD=7.80, 95% CI=4.15 to 11.45, p<0.0001), and physical function (SMD= -0.32, 95% CI= -0.51 to -0.13, p=0.0007) after CFA intervention. No significant difference was observed in the degree of knee stiffness. As for the subgroup analysis, the significant improvements in pain, ROM, and physical function only observed when using oral CFA capsules instead of CFA cream. CONCLUSIONS: Overall, CFAs may improve pain levels, knee ROM, and physical function in patients with knee OA, particularly the oral form. Further research is required to determine the synergic effects as a supplementary regimen, longer term effects, and safety profiles of CFAs in patients with knee OA.

The purpose of this study was to ascertain whether an oral, non-prescription, nutritional supplement compound composed of a proprietary alkali-buffered creatine monohydrate and cetylated fatty acids mixture (Kre-Celazine(®)) was efficacious in reducing or eliminating refractory pain and inflammation, without untoward effects, in Juvenile Rheumatoid Arthritis (JRA), which is also called Juvenile Idiopathic Arthritis (JIA). JRA/JIA is a patho-physiologically complex, chronic childhood autoimmune inflammatory disease of unknown etiology. Numerous studies have unsuccessfully attempted to pinpoint a possible common initiation event. Officially considered an affliction of children below the age of 16 years, an initial diagnosis has been confirmed in infants less than 1 year old, to individuals older then 17 years. In this study, sixteen juveniles, ages 7 through 16 years, experiencing long-standing, unremitting pain and inflammation despite previous use of prescription anti-inflammatory drugs and NSAIDs, were enrolled in a 30-day, open-label clinical study and treated with Kre-Celazine. Efficacy of this nutritional supplement was determined by the juvenile's personal physician and based on observations of the following: (1) significant reduction or elimination of palpable signs of inflammation; (2) renormalization of range of motion; (3) reduction or absence of perceived pain as reported to the physician by the patient; (4) renormalization of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) values. In addition, the individual's previous steroid or non-steroidal anti-inflamatory medication(s) were reduced or eliminated in a stepwise progressive fashion during the study.

The influence of a proprietary blend of modified cellulose and cetylated fatty acids (Trisynextrade mark, Imagenetix, Inc., San Diego, CA 92127, USA) on adipocytokine and regional body composition responses to a weight loss program was examined. Twenty-two women (Supplement group (S) (n = 11): age = 36.8 +/- 7.2 years; weight = 87.1 +/- 6.2 kg; % body fat = 43.4 +/- 4.1; Placebo group (P) (n = 11): age = 38.3 +/- 6.8 years; weight = 86.9 +/- 4.7 kg; % body fat = 44.3 +/- 2.0) completed an 8-week placebo-controlled, double-blind study consisting of a caloric restricted diet and cardiovascular exercise. Body composition and serum insulin, leptin, and adiponectin were assessed at pre-, mid-, and post-intervention. From pre- to post-intervention, significant decreases (P < 0.05) were observed for body weight (S: 87.1 +/- 6.2-77.9 +/- 5.1 kg; P: 86.9 +/- 4.7-82.7 +/- 3.8 kg) (P < 0.05 S vs. P), % body fat (S: 43.4 +/- 4.1-36.1 +/- 3.6; P: 44.3 +/- 2.0-40.6 +/- 1.2) (P < 0.05 S vs. P), leptin (S: 28.3 +/- 3.5-16.2 +/- 2.6 ng ml(-1); P: 29.4 +/- 3.2-19.9 +/- 1.1 ng ml(-1)) (P < 0.05 S vs. P), and insulin (S: 7.3 +/- 0.8-5.1 +/- 0.2 mU l(-1); P: 7.7 +/- 0.9-5.1 +/- 0.3 mU l(-1)). Serum adiponectin increased (P < 0.05) (S: 12.2 +/- 2.4-26.3 +/- 3.0 microg ml(-1): 12.6 +/- 2.0-21.8 +/- 3.1 microg ml(-1)) (P < 0.05 for S vs. P). Supplementation with a proprietary blend of modified cellulose and cetylated fatty acids during an 8-week weight loss program exhibited favorable effects on adipocytokines and regional body composition.

OBJECTIVE: To assess and compare the skin calming effect of cosmetic products containing 4-t-butylcyclohexanol (Eucerin(®) UltraSensitive Soothing Care Dry Skin) or acetyl dipeptide-1 cetyl ester (La Roche-Posay Toleriane(®) Ultra Intense Soothing Care) on subjective symptoms of skin sensitivity, a controlled, single-blind, randomized split-face capsaicin-induced stinging test was conducted. METHODS: Thirty-one female test subjects, ranging from 19 to 65 years of age, with self-perceived sensitive to very sensitive skin were enrolled. After a 3-day preconditioning period with no application of facial products and positive reaction to stimulation with a 40 ppm capsaicin cream, the test products were randomly applied to either the right or left nasolabial fold. Burning severity was assessed immediately after capsaicin application, and 1, 2, 5, 10 and 15 min after application of the test products. RESULTS: All 31 subjects reported a stinging/burning sensation on both nasolabial folds after application of capsaicin. Treatment with the 4-t-butylcyclohexanol containing product resulted in significant lower values for burning/stinging after one, and two minutes post-application in comparison to the values for the acetyl dipeptide-1 cetyl ester containing product. No significant difference was determined between the two test products for the point in time with most intense burning sensation, the severity of burning and the duration of burning after capsaicin application and subsequent application of the test products. CONCLUSION: Both products alleviated capsaicin-induced burning during the first 15 min after application. A faster and more pronounced soothing effect in vivo was demonstrated for the 4-t-butylcyclohexanol containing cosmetic product in comparison to the acetyl dipeptide-1 cetyl ester containing cosmetic formulation. © 2016 European Academy of Dermatology and Venereology.

BACKGROUND: More than 50% of adults report to suffer from sensitive skin. This common condition is characterized by subjective sensations such as prickling, burning, skin tightness or pruritus, and is often accompanied by objective symptoms like inflammation and erythema. OBJECTIVE: The objective of this study was to develop an active ingredient concept for the treatment of sensitive skin. We tested compounds regarding their potential to (i) decrease the release of proinflammatory mediators, which among others induce erythema and (ii) counteract the hyperresponsiveness of nerve fibres and, thus, exert effects on cutaneous neurosensory dysfunction. METHODS: 4-t-butylcyclohexanol, licochalcone A and acetyl dipeptide-1 cetyl ester were analysed in vitro regarding their potential to (i) decrease the release of PGE2 and activation of NFκB and to (ii) inhibit TRPV1 activation or the release of neuronal CGRP. To assess subjective and objective symptoms of skin sensitivity in vivo, two controlled, single-blind, randomized studies were conducted with 4-t-butylcyclohexanol and the combination with licochalcone A. RESULTS: In vitro, 4-t-butylcyclohexanol significantly reduced TRPV1 activation, while acetyl dipeptide-1 cetyl ester had no effect on receptor activation. Licochalcone A significantly decreased NFκB signalling and PGE2 secretion, at lower concentrations than acetyl dipeptide-1 cetyl ester. A formulation containing 4-t-butylcyclohexanol showed a significant immediate anti-stinging/anti-burning effect in vivo, and a cream base containing a combination of 4-t-butylcyclohexanol and a licochalcone A-rich licorice extract reduced shaving-induced erythema. CONCLUSION: In vitro and in vivo data indicate that the combination of the TRPV1 antagonist 4-t-butylcyclohexanol and the potent anti-inflammatory licochalcone A provide an effective active ingredient concept for the treatment of sensitive skin, as the topical application resulted in an immediate relief from symptoms such as erythema and stinging. © 2016 European Academy of Dermatology and Venereology.

Humectant and occlusive technologies have traditionally been used for the treatment of dry skin. Originally, non-lamellar-forming ingredients were used such as petrolatum but recent research has shown the advantage of using lamellar-forming ingredients such as ceramides, pseudoceramides and phospholipids in the relief of dry skin. Nevertheless, the importance of using lipid-phase transition inducers, such as long-chain fatty acids, has not been studied clinically. The evaluation of a novel complex of lipophilic ingredients was of interest: cetyl alcohol, isostearyl isostearate, potassium cetyl phosphate, cetyl behenate and behenic acid. The combination of all these ingredients was shown to be more effective than any single component in water vapour transmission rate studies. This was thought to be owing to the formation of a unique structural organization of the lipids upon dry-down from an O/W emulsion as was examined by X-ray diffraction and optical microscopy. When evaluated clinically in a randomized double-blind and vehicle-controlled moisturization efficacy trial, this novel blend of ingredients was shown to not only improve the visible signs of skin dryness to a significantly greater extent than a comparable mineral oil-containing vehicle but also then maintain a better skin condition during the regression no-treatment phase of the study. This combination of ingredients offers a new technology option for the treatment of dry skin. © 2012 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Participants with Myofascial Pain Syndrome (MPS) of the neck were randomly assigned into 2 groups of the double-blinded study: topical cetylated fatty ester complex (CFEC) cream application plus physical therapy (CF-PT; n=37), and placebo cream application plus physical therapy (PL-PT; n=35). There were 3 visits during 4 weeks of treatment. Physical Therapy (PT), given twice/week, included Ischaemic Compression, Deep Pressure Trigger Point Massage and Myofascial Releases. Topical cream [CFEC cream (5.6%) and 1.5% menthol] or placebo cream [1.5% menthol, in a cream base] was applied twice/day. CF-PT provided the fastest and most effective study treatment modality. The addition of CFEC cream to PT resulted in statistically significant improvements, compared to PL-PT, for reduction of pain, neck disability and life quality indicators. Our results indicate that cetylated derivatives of fatty acids can effectively reduce pain and symptoms associated with neck MPS, when combined with physical therapy.

Erratum in J Strength Cond Res. 2005 May;19(2):244. Salvestre, Ricardo [corrected to Silvestre, Ricardo]. The purpose of the present investigation was to examine the effects of 30 days of treatment with a topical cream consisting of cetylated fatty acids on static postural stability and plantar pressures in patients with osteoarthritis (OA) of one or both knees. Forty patients diagnosed with knee OA were randomly assigned to 1 of 2 topical treatment groups: (a) cetylated fatty acid (CFA; N = 20; age = 62.7 +/- 11.7 years); or (b) placebo (P; N = 20; age = 64.6 +/- 10.5 years). Patients were tested on 2 occasions: (a) baseline (T1), and (b) following a 30-day treatment period consisting of cream application twice per day (T2). Assessments included 20- and 40-second quiet standing protocols on a force plate to measure center of pressure (COP) total excursion length, COP velocity, and rearfoot and forefoot plantar pressure distribution. In the CFA group, a significant reduction in the COP excursion length and velocity were observed at T2, whereas no significant differences were observed in the P group. No significant differences in mean forefoot, rearfoot, or rearfoot-to-forefoot plantar pressure ratios were observed in either group at T2. However, in a subgroup of participants designated to be right- or left-side dominant, improvements in the right-to-left forefoot plantar pressure ratios were observed in both groups. These data indicate that 30 days of treatment with a topical cream consisting of cetylated fatty acids improves static postural stability in patients with knee OA presumably due to pain relief during quiet standing. Such over-the-counter treatment may help improve the exercise trainability of people with OA.

BACKGROUND: C31G is an antimicrobial and spermicidal agent that contains two surface-active compounds, cetyl betaine and myristamine oxide. It is being developed as a vaginal microbicide and contraceptive. METHOD: Three C31G concentrations (0.5%, 1.0% and 1.7%) were tested and compared with Extra Strength Gynol II(R), a marketed spermicide containing 3% nonoxynol-9 (N-9), in a randomized, double-blinded, Phase I, dose-escalation study to assess genital irritation (by subject report, visual examination at pelvic examination and colposcopy), plasma and vaginal lavage levels of C31G, product leakage, systemic safety and acceptability. Women were randomized to use 3.5 mL of one of the three C31G products or the N-9 gel at night for 7 days then twice daily for another 7 days. Pelvic and colposcopic evaluations were performed after 7 and 14 days of product use. RESULTS: The percent of women experiencing irritation in the 0.5% and 1.0% C31G groups in the study were similar to each other and were lower than the percent experiencing irritation in the 1.7% and N-9 groups, which were also similar to each other. Differences were statistically significant between 1.0% C31G vs. N-9 at 7 days and between 0.5% C31G and 1.0% C31G vs. N-9 at 14 days. There was no significant difference between groups in leakage or acceptability. No C31G was detected in the plasma of any volunteer. CONCLUSIONS: These results suggest that 0.5% and 1.0% C31G are less irritating to the female genital tract than 1.7% C31G or Extra Strength Gynol II.

OBJECTIVE: To examine the effect of a topical cream consisting of cetylated fatty acids on functional performance in patients diagnosed with osteoarthritis (OA) of one or both knees. METHODS: Forty patients diagnosed with knee OA were randomly assigned to one of 2 topical treatment groups: (1) cetylated fatty acid (CFA) (n = 20; age 62.7 +/- 11.7 yrs); or (2) placebo group (n = 20; age 64.6 +/- 10.5 yrs). Patients were tested on 3 occasions: (1) baseline (T1), (2) 30 min after initial treatment (T2), and (3) after 30-day treatment of cream application twice per day (T3). Assessments included knee range of motion (ROM), timed "up-and-go" from a chair and stair climbing, medial step-down test, and the unilateral anterior reach. RESULTS: For stair climbing ability and the up-and-go test, significant decreases in time were observed at T2 and T3 compared to T1 in the CFA group only. These differences were significant between groups. Supine ROM of the knees increased at T2 and T3 in CFA group, whereas no difference was observed in the placebo group. For the medial step-down test, significant improvement was observed at T2 and T3 compared to T1 in CFA group. For the unilateral anterior reach, significant improvement was observed for both legs in CFA group and in only the left leg in the placebo group. However, the improvements observed in CFA group were significantly greater than placebo group for both legs. CONCLUSION: Use of a CFA topical cream is an effective treatment for improving knee ROM, ability to ascend/descend stairs, ability to rise from sitting, walk and sit down, and unilateral balance.

OBJECTIVE: To determine the benefit of cetylated fatty acids (CFA) on knee range of motion and function in patients with osteoarthritis (OA). METHODS: Sixty-four patients with chronic knee OA were evaluated at baseline and at 30 and 68 days after consuming either placebo (vegetable oil; n = 31) or CFA (Celadrin; n = 33). Evaluations included physician assessment, knee range of motion with goniometry, and the Lequesne Algofunctional Index (LAI). RESULTS: After 68 days, patients treated with CFA exhibited significant (p < 0.001) increase in knee flexion (10.1 degrees) compared to patients given placebo (1.1 degrees). Neither group reported improvement in knee extension. Patient responses to the LAI indicated a significant (p < 0.001) shift towards functional improvement for the CFA group (-5.4 points) after 68 days compared to a modest improvement in the placebo group (-2.1 points). CONCLUSION: Compared to placebo, CFA provides an improvement in knee range of motion and overall function in patients with OA of the knee. CFA may be an alternative to the use of nonsteroidal antiinflammatory drugs for the treatment of OA.