After being recruited into the study, every subject received a knee X-ray, which indicated severity according to Kellgren–Lawrence criteria.24 Then, all participants were randomly allocated to receive either 1,200 mg/day of ibuprofen or 1,500 mg/day of C. domestica extracts. For blinding patients and assessors, both medications were manufactured by the Department of Pharmacy, Siriraj Hospital, Bangkok, Thailand, in the form of a capsule, to make them identical in appearance. The treatment codes were kept by a pharmacist who was not involved in the study process.