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The placebo group's 40.3% pain reduction is substantial and reflects a well-documented placebo effect in OA trials, plus natural history improvement from lifestyle counseling
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Immature osteoblasts activate intracellular protein kinase A (PKA), protein kinase C (PKC), and calcium signal pathways under PTH signaling stimulation, induce osteoclast activation and differentiation, and then establish bone resorption (Rendina-Ruedy and Rossen, 2022)
SGLT2i also decrease insulin resistance, blood pressure and body mass, while not causing hypoglycemia (124)
