Comparison of weight loss interventions in overweight and obese adults with knee osteoarthritis: A systematic review and network meta-analysis of randomized trials.

OBJECTIVE: To ascertain the comparative effectiveness of weight-loss strategies for osteoarthritis (OA) to develop rational treatment algorithms aimed at improving OA-related symptoms in overweight/obese individuals. DESIGN: Medline, Embase, CINAHL, Scopus, and Web of Science were searched from inception to June 2023 for observational studies and randomized trials. Network meta-analyses were performed using a frequentist approach. Effect sizes for pain and function were computed as standardized mean differences, while change in body weight was computed as mean differences. RESULTS: 13 RCTs on knee OA (KOA) (2800 participants) with 7 interventions: diet (D); exercise (E); diet and exercise (DE); pharmacological (L); psychological (P); psychological, diet, and exercise (PDE); and Mediterranean diets (M) were networked. For weight change (kg), all interventions significantly outperformed control comparators, with effect sizes ranging from -11.2 (95% CI, -16.0, -6.5 kg) for the most effective approach (PDE) to -4.7 (95% CI, -6.7, -2.7 kg) for the least effective approach (DE). In terms of pain (0-20 scale), only DE outperformed control comparators (-2.2, 95% CI: -4.1, -0.21), whereas PDE was not superior to control comparators (-3.9, 95% CI: -8.4, 0.5) in improving the pain. Regardless of the chosen intervention, prediction intervals from meta-regression analysis indicate that significant pain relief may be anticipated when patients achieve at least a weight reduction of 7%. CONCLUSIONS: PDE and DE interventions may offer the most effective approach for weight loss, potentially leading to improvements in pain and physical function among overweight/obese individuals with KOA if they achieve more than 7% weight loss.

Efficacy and safety of an oral complementary medicine combination in people with symptomatic knee osteoarthritis: Protocol for the double-blind, randomized, placebo-controlled ATLAS trial.

Objective: To investigate the efficacy and safety of an oral complementary medicine combination formulation relative to placebo, on changes in pain intensity from baseline to week 12, in people with knee osteoarthritis (OA). Design: A placebo-controlled, double-blind, two-arm, superiority, phase II, Randomized Controlled Trial (RCT) (ACTRN12623000380695). We will recruit 82 participants (∼41 per arm), aged ≥40 years, with a clinical diagnosis of symptomatic knee OA and radiographic change on x-ray (Kellgren-Lawrence Grade ≥2). Participants will be randomly allocated to receive either a complementary medicine formulation containing a daily dose of Boswellia serrata extract (Boswellin® Super, 250 â€‹mg/day), pine bark extract (Fenoprolic™ 70 Organic 100 â€‹mg/day), curcumin (500 â€‹mg/day), piperine (5 â€‹mg/day), and methylsulfonylmethane (MSM, 1500 â€‹mg/day), or placebo, for 12-weeks. The primary endpoint will be change from baseline in average knee pain intensity at 12-weeks (visual analogue scale). Secondary endpoints will include change in knee pain from baseline to 12-weeks in the Knee Injury and Osteoarthritis Outcome Score (KOOS), global assessment of disease activity, global rating of change, and health-related quality of life (AQoL-8D). Ethics and dissemination: This protocol has been approved by the University of Sydney Human Research Ethics Committee (#2021/877). Dissemination will occur through lay summaries, infographics, conference abstracts, oral presentations, theses, and scientific publications. Conclusion: This RCT will provide credible evidence about the efficacy and safety of this complementary medicine combination and inform updates to international clinical practice standards on the use of complementary medicines in the management of symptomatic knee OA.

Exploring the astonishing beneficial effects of round gourd (Praecitrullus fistulosus) and plant lectins towards cancer: A comprehensive review.

Praecitrullus fistulosus, commonly known as round gourd or tinda, is a remarkable source of bioactive substances like polyphenols, antioxidants, carotene, magnesium, and vitamin C. It is considered one of the Cucurbitaceae family due to its medicinal features. Plant lectins are carbohydrate-binding proteins that can bind and identify the carbohydrate moieties upon cancerous cells demonstrated some anticancer potentials. Several plant lectins are helpful as cancer biomarkers because they can find cancer cells and contribute to cell death initiation via apoptosis and autophagy, suggesting the possible role of cancer-inhibiting pathways. Therefore, round gourd and lectins might be useful in the controlling of cancer. This study compiled the most recent scientific literature regarding the round gourd and numerous plant lectins, and the clinical trials of lectins exploring their effects on cancer were examined. Research according to the literature, round gourd, and lectins demonstrated pharmacological alterations not only in cancer but in many other disorders as well. Thus, clinical investigations proved the beneficial impacts of round gourd and lectins on cancer due to their antioxidants, anti-inflammatory, and anticarcinogenic properties. Further studies are required to fully comprehend the potential applications of these plant-derived compounds against cancer, as well as to identify the round gourd components and clarify their mode of action.

Therapeutic potential of mangiferin in cancer: Unveiling regulatory pathways, mechanisms of action, and bioavailability enhancements - An updated review.

Mangiferin (MGF) is a phenolic compound, which is a major source of MGF is the mango tree. MGF possesses some antioxidant, anti-inflammatory, and cytoprotective properties, enabling it to play its role against various diseases such as diabetes, obesity, lung injuries, and cancer. The word "Cancer" depicts an uncontrolled and abnormal growth of cells. This review paper reveals MGF's therapeutic, curative and protective potential impact against lung, liver, ovarian, prostate, breast, stomach, and oral cancers. MGF is used in various types of research in the form of powder, liquid extract, intramuscular, intravenous, nanoparticles coated with gold, in the form of a solution, or in combination with other drugs to evaluate synergistic effects. Many studies showed that MGF is safe to use but has less bioavailability in the body and 0.111 mg/mL solubility in water. However, certain studies indicated that its bioavailability and retention time increased when taken in the form of nanoparticles and in combination with other drugs. MGF also increases the sensitivity of other drugs (i.e., cisplatin) resistant to tumors. MGF has different mechanisms of action for different cancers. It mainly targets enzymes, interleukins, tumor growth factors, signaling pathways, apoptotic proteins, and genes to inhibit the growth of tumors, volume, angiogenesis, cellular functionality, further progression, and movement to other areas of the body. Moreover, MGF increases apoptosis and body weight with no or fewer side effects on normal cells. MGF unveiled a novel gate toward the treatment of cancer. Further research and human trials are needed in this regard.