TY - JOUR
T1 - Krill Oil for Knee Osteoarthritis
T2 - A Randomized Clinical Trial
AU - Laslett, Laura L.
AU - Scheepers, Lieke E.J.M.
AU - Antony, Benny
AU - Wluka, Anita E.
AU - Cai, Guoqi
AU - Hill, Catherine L.
AU - March, Lyn
AU - Keen, Helen I.
AU - Otahal, Petr
AU - Cicuttini, Flavia M.
AU - Jones, Graeme
N1 - Funding Information:
Funding/Support: The KARAOKE study is funded by a project grant from the National Health and Medical Research Council of Australia (NHMRC; grant 1102732) and the University of Tasmania. Drs Laslett and Antony were supported by NHMRC Early Career Fellowships (1070586 and 1122596). Dr Scheepers is a recipient of the Farrell Family Research Fellowship. Dr Wluka is a recipient of an NHMRC TRIP Fellowship (1150102) and an RACP Fellows Career Development Fellowship (2020). Dr Cai is supported by the National Natural and Science Foundation of China (grant 82103933). Dr Jones is a recipient of an NHMRC Practitioner Fellowship (1023222). Additional in-kind support was received from Aker Biomarine (provision of krill oil and placebo softgels and processing of blood for the Omega-3 Index).
Funding Information:
Conflict of Interest Disclosures: Dr Cai reported receipt of grants from the National Natural Science Foundation of China. Dr Hill reported receipt of grants from the University of Adelaide. Dr March reported receipt of grants from the Medical Research Future Fund Australia (to institution). Dr Keen reported being an investigator for various pharmaceutical trials and doing paid talks for Roche. No other disclosures were reported.
Publisher Copyright:
© 2024 American Medical Association. All rights reserved.
PY - 2024/6/18
Y1 - 2024/6/18
N2 - Importance: Knee osteoarthritis is disabling, with few effective treatments. Preliminary evidence suggested that krill oil supplementation improved knee pain, but effects on knee osteoarthritis remain unclear. Objective: To evaluate efficacy of krill oil supplementation, compared with placebo, on knee pain in people with knee osteoarthritis who have significant knee pain and effusion-synovitis. Design, Setting, and Participants: Multicenter, randomized, double-blind, placebo-controlled clinical trial in 5 Australian cities. Participants with clinical knee osteoarthritis, significant knee pain, and effusion-synovitis on magnetic resonance imaging were enrolled from December 2016 to June 2019; final follow-up occurred on February 7, 2020. Interventions: Participants were randomized to 2 g/d of krill oil (n = 130) or matching placebo (n = 132) for 24 weeks. Main Outcomes and Measures: The primary outcome was change in knee pain as assessed by visual analog scale (range, 0-100; 0 indicating least pain; minimum clinically important improvement = 15) over 24 weeks. Results: Of 262 participants randomized (mean age, 61.6 [SD, 9.6] years; 53% women), 222 (85%) completed the trial. Krill oil did not improve knee pain compared with placebo (mean change in VAS score, -19.9 [krill oil] vs -20.2 [placebo]; between-group mean difference, -0.3; 95% CI, -6.9 to 6.4) over 24 weeks. One or more adverse events was reported by 51% in the krill oil group (67/130) and by 54% in the placebo group (71/132). The most common adverse events were musculoskeletal and connective tissue disorders, which occurred 32 times in the krill oil group and 42 times in the placebo group, including knee pain (n = 10 with krill oil; n = 9 with placebo), lower extremity pain (n = 1 with krill oil; n = 5 with placebo), and hip pain (n = 3 with krill oil; n = 2 with placebo). Conclusions and Relevance: Among people with knee osteoarthritis who have significant knee pain and effusion-synovitis on magnetic resonance imaging, 2 g/d of daily krill oil supplementation did not improve knee pain over 24 weeks compared with placebo. These findings do not support krill oil for treating knee pain in this population.
AB - Importance: Knee osteoarthritis is disabling, with few effective treatments. Preliminary evidence suggested that krill oil supplementation improved knee pain, but effects on knee osteoarthritis remain unclear. Objective: To evaluate efficacy of krill oil supplementation, compared with placebo, on knee pain in people with knee osteoarthritis who have significant knee pain and effusion-synovitis. Design, Setting, and Participants: Multicenter, randomized, double-blind, placebo-controlled clinical trial in 5 Australian cities. Participants with clinical knee osteoarthritis, significant knee pain, and effusion-synovitis on magnetic resonance imaging were enrolled from December 2016 to June 2019; final follow-up occurred on February 7, 2020. Interventions: Participants were randomized to 2 g/d of krill oil (n = 130) or matching placebo (n = 132) for 24 weeks. Main Outcomes and Measures: The primary outcome was change in knee pain as assessed by visual analog scale (range, 0-100; 0 indicating least pain; minimum clinically important improvement = 15) over 24 weeks. Results: Of 262 participants randomized (mean age, 61.6 [SD, 9.6] years; 53% women), 222 (85%) completed the trial. Krill oil did not improve knee pain compared with placebo (mean change in VAS score, -19.9 [krill oil] vs -20.2 [placebo]; between-group mean difference, -0.3; 95% CI, -6.9 to 6.4) over 24 weeks. One or more adverse events was reported by 51% in the krill oil group (67/130) and by 54% in the placebo group (71/132). The most common adverse events were musculoskeletal and connective tissue disorders, which occurred 32 times in the krill oil group and 42 times in the placebo group, including knee pain (n = 10 with krill oil; n = 9 with placebo), lower extremity pain (n = 1 with krill oil; n = 5 with placebo), and hip pain (n = 3 with krill oil; n = 2 with placebo). Conclusions and Relevance: Among people with knee osteoarthritis who have significant knee pain and effusion-synovitis on magnetic resonance imaging, 2 g/d of daily krill oil supplementation did not improve knee pain over 24 weeks compared with placebo. These findings do not support krill oil for treating knee pain in this population.
UR - http://www.scopus.com/inward/record.url?scp=85194256148&partnerID=8YFLogxK
U2 - 10.1001/jama.2024.6063
DO - 10.1001/jama.2024.6063
M3 - Article
C2 - 38776073
AN - SCOPUS:85194256148
SN - 0098-7484
VL - 331
SP - 1997
EP - 2006
JO - JAMA
JF - JAMA
IS - 23
ER -