E047 Efficacy and safety of cetylated fatty acids in osteoarthritis: a systematic review and meta-analysis

Background/Aims Osteoarthritis (OA) is a major cause of pain and disability worldwide. Current management often relies on non-steroidal anti-inflammatory drugs (NSAIDs), which carry long-term safety concerns. Cetylated fatty acids (CFAs) have been proposed as adjunctive therapies due to their purported anti-inflammatory and lubricating properties. This study evaluated the effectiveness of CFAs in reducing pain and improving functional outcomes in adults with osteoarthritis. Methods We conducted a systematic review and meta-analysis in accordance with PRISMA and Cochrane guidelines (PROSPERO ID: CRD420251009414). PubMed, EMBASE, and Scopus were searched from inception to March 2025, with an updated search conducted up to September 2025. Eligible studies included randomized controlled trials (RCTs) and observational studies assessing CFAs in adults with OA. The primary outcome was a change in pain scores. Secondary outcomes included physical function, stiffness, and adverse events. Results Seven studies (n = 347) met inclusion criteria; five RCTs (n = 277) contributed to quantitative synthesis. The pooled analysis revealed that CFAs resulted in a significant reduction in pain compared to the control group, with a moderate effect size (SMD = −0.68, 95% CI − 0.93 to − 0.44; p < 0.00001). Between-study heterogeneity was negligible (I² = 0%), and the direction of effect was consistent across individual comparisons. Conclusion CFAs are associated with a statistically significant analgesic benefit in osteoarthritis, with highly consistent effects across trials. While encouraging, these findings derive from a small evidence base, and it is unclear whether this effect is clinically meaningful; larger, rigorously designed, placebo-controlled RCTs with standardized pain and function outcomes and longer follow-up are needed to define optimal formulation, dosing, and durability of benefit. Disclosure L. Kayyal: None. J. O’Logbon: None. A. Viswanath: None. A. Silveira Freitas: None. L. Bertão de Oliveira: None.