PO:29:138 | Cetylated fatty acids and fibromyalgia: efficacy and tolerability in a prospective study

Anna Capogna¹, Marco Bardelli¹, Luca Cantarini¹, Bruno Frediani¹ | ¹UOC Reumatologia, Dipartimento di Scienze mediche, chirurgiche e neuroscienze, Università degli Studi di Siena, Italy

Background. Fibromyalgia (FM) is a syndrome characterized by chronic widespread pain, fatigue, sleep disturbances, and cognitive impairment, in the absence of organic lesions. It is often associated with comorbidities such as headache, anxiety, irritable bowel syndrome, hypothyroidism, and endometriosis. (1) Currently classified among central sensitization syndromes, FM is thought to be sustained by dysfunction in nociceptive processing within the central nervous system. (2) Given the lack of a universally effective therapy and the limited tolerability of conventional pharmacological agents in many patients, there is growing interest in the use of nutraceutical supplements as adjunctive treatment. Among these, cetylated fatty acids (CFAs)—natural lipophilic esters of fatty acids and cetyl alcohol—have been reported to exhibit excellent tolerability and potential analgesic properties. (3)(4) It has been further hypothesized that such effects may, at least in part, be mediated through modulation of the endocannabinoid system, specifically via inhibition of monoacylglycerol lipase (MAGL), resulting in increased levels of 2-arachidonoylglycerol (2-AG) and subsequent activation of CB1 and CB2 receptors. (5)

Materials and Methods. The study enrolled a total of 45 patients with fibromyalgia (FM), diagnosed according to the 2016 ACR/EULAR criteria (14 males, 31 females; mean age: 54 years). All participants received one stick per day of cetylated fatty acids (Lipocet®) for a duration of 60 days. The following outcome measures were evaluated: – Visual Analog Scale (VAS) for pain; – Fatigue Severity Scale (FSS); – Health Assessment Questionnaire (HAQ). Assessments were conducted at baseline (T0), after 40 days of treatment (T1), after 60 days of treatment (T2), and 30 days following treatment discontinuation (T3).

Results. The analysis revealed a significant reduction in VAS and FSS scores between T0 and T1, as well as between T1 and T2. HAQ scores showed a significant improvement from T1 to T2. Following treatment discontinuation (T3), no statistically significant worsening was observed, and all parameters remained improved compared with baseline. Importantly, no patient discontinued treatment due to intolerance or adverse effects.

Conclusions. Cetylated fatty acids demonstrated clinically relevant effects in reducing pain and muscle fatigue, with a concomitant improvement in quality of life among patients with fibromyalgia. The therapeutic benefit emerged within the initial weeks of treatment and persisted, at least partially, following treatment withdrawal. Considering their favorable safety and tolerability profile, and the absence of treatment-limiting adverse events, Lipocet® may be regarded as a promising complementary strategy within the multimodal management of fibromyalgia, particularly in individuals with suboptimal response or poor tolerability to conventional pharmacological therapies.