Farid 2007.

Methods	Randomised, double‐blind, placebo control, 2 parallel groups. Duration 3 months (˜12 weeks)
Participants	Randomised n=37; intervention n=19, control n=18. Completed n=35. Mean age: control 48.9 yrs, intervention 47.5yrs. M:F: control 1:17, intervention 2:18. Inclusion: OA knee (ACR criteria)
Interventions	Pycnogenol®: Pinus pinaster, pine bark extract with 70% proanthocyanines, 150mg (3 x 50mg), tablets Placebo control: "inactive ingredient", ingredients not report, tablets
Outcomes	WOMAC‐VAS (aggregated scores), NSAID/COX‐2 inhibitor use
Notes	Exploratory study design; power, effect, and sample size not determined a priori. Reported ethics committee approval. Results favour intervention.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Described as randomised, method not reported
Allocation concealment (selection bias)	Unclear risk	Adequate concealment not reported
Blinding (performance bias and detection bias) All outcomes	Low risk	Described as double‐blind. Active intervention and placebo not distinguished by look, taste, smell or packaging
Incomplete outcome data (attrition bias) All outcomes	Low risk	Reported withdrawals. Reported identical per‐protocol and intention‐to‐treat analyses
Selective reporting (reporting bias)	Unclear risk	Reported no adverse events (low risk)
Other bias	Low risk	Diagnosis / assessment based on ACR criteria