{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T03:44:39Z","timestamp":1788925479054,"version":"build-2803163510"},"reference-count":54,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T00:00:00Z","timestamp":1693267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003052","name":"Ministry of Trade, Industry and Energy","doi-asserted-by":"publisher","award":["P0000784"],"award-info":[{"award-number":["P0000784"]}],"id":[{"id":"10.13039\/501100003052","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003052","name":"Ministry of Trade, Industry and Energy","doi-asserted-by":"publisher","award":["P0017150"],"award-info":[{"award-number":["P0017150"]}],"id":[{"id":"10.13039\/501100003052","id-type":"DOI","asserted-by":"publisher"}]},{"name":"World Class Plus Program","award":["P0000784"],"award-info":[{"award-number":["P0000784"]}]},{"name":"World Class Plus Program","award":["P0017150"],"award-info":[{"award-number":["P0017150"]}]},{"name":"NOVAREX Co., Ltd.","award":["P0000784"],"award-info":[{"award-number":["P0000784"]}]},{"name":"NOVAREX Co., Ltd.","award":["P0017150"],"award-info":[{"award-number":["P0017150"]}]},{"name":"Valensa International","award":["P0000784"],"award-info":[{"award-number":["P0000784"]}]},{"name":"Valensa International","award":["P0017150"],"award-info":[{"award-number":["P0017150"]}]}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Nutrients"],"abstract":"<jats:p>Osteoarthritis is a significant global health problem. Many patients seek more effective alternatives to nonsteroidal anti-inflammatory medicines or commercial supplements to manage joint pain and inflammation. FlexPro MD\u00ae (FP-MD) combines krill oil, astaxanthin, and lower molecular weight hyaluronic acid to support joint health. A 12-week, randomized, double-blind, placebo-controlled trial compared the efficacy and safety of FP-MD and placebo once daily in participants (n = 100) with mild osteoarthritis of the knee or hip joint. For the primary endpoint of joint pain score, per-protocol participants (n = 75) in the FP-MD group (n = 37) had a statistically significantly greater mean reduction from baseline in the Korean Visual Analog Scale (K-VAS) at week 12 compared with participants in the placebo group (n = 38) (20.8 \u00b1 16.16 mm vs. 10.6 \u00b1 17.58, p = 0.0105). The Korean Western Ontario and McMaster Universities Osteoarthritis Index (K-WOMAC) total score was also significantly improved in the FP-MD group at week 12 compared with placebo (\u221213.0 \u00b1 13.62 vs. \u22125.5 \u00b1 18.08, p = 0.0489), especially an improvement in pain score (\u22122.5 \u00b1 2.92 vs. \u22121.3 \u00b1 3.94, p = 0.02635). FP-MD group had greater improvement in joint function scoring by investigator assessment (p = 0.0127) and by group participants (p = 0.0070). A statistically significantly greater number of patients reported adverse events in the placebo group compared with the FP-MD group (16% vs. 4%, p = 0.0455), most commonly gastrointestinal disorders in both of the groups. These findings suggest that FP-MD is well tolerated and can be effectively used to address joint pain in patients diagnosed with mild osteoarthritis, the main symptom of this condition.<\/jats:p>","DOI":"10.3390\/nu15173769","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T08:51:14Z","timestamp":1693299074000},"page":"3769","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["A Multicenter, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial to Evaluate the Efficacy and Safety of a Krill Oil, Astaxanthin, and Oral Hyaluronic Acid Complex on Joint Health in People with Mild Osteoarthritis"],"prefix":"10.3390","volume":"15","author":[{"given":"W. Stephen","family":"Hill","sequence":"first","affiliation":[{"name":"US Nutraceuticals, Inc. d\/b\/a Valensa International, Eustis, FL 32726, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret H.","family":"Dohnalek","sequence":"additional","affiliation":[{"name":"US Nutraceuticals, Inc. d\/b\/a Valensa International, Eustis, FL 32726, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yejin","family":"Ha","sequence":"additional","affiliation":[{"name":"NOVAREX Co., Ltd., 80, Osongsaengmyeong 14-ro, Osong-eup, Chueongju-si 28220, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9116-8786","authenticated-orcid":false,"given":"Seok-Jung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Uijeongbu St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Cheonbo-ro, Uijeongbu-si 11765, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Chul","family":"Jung","sequence":"additional","affiliation":[{"name":"NOVAREX Co., Ltd., 80, Osongsaengmyeong 14-ro, Osong-eup, Chueongju-si 28220, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Baik","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Seoul National University College of Medicine, Boramae Hospital, Seoul 07061, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1002\/art.41571","article-title":"Prevalence, Deaths, and Disability-Adjusted Life Years Due to Musculoskeletal Disorders for 195 Countries and Territories 1990\u20132017","volume":"73","author":"Safiri","year":"2021","journal-title":"Arthritis Rheumatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1136\/annrheumdis-2019-216515","article-title":"Global, regional and national burden of osteoarthritis 1990\u20132017: A systematic analysis of the Global Burden of Disease Study 2017","volume":"79","author":"Safiri","year":"2020","journal-title":"Ann. 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