Boswellia serrata may reduce symptoms of osteoarthritis Original paper

In this meta-analysis of randomized controlled trials, supplementation with products containing Boswellia serrata extract improved symptoms of osteoarthritis.

The effect of supplementation with products containing Boswellia serrata (BS) extract on symptoms of osteoarthritis.

Specifically, the following outcomes were studied:

• Pain assessed using a visual analog scale (VAS)
• Pain assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) scale
• Stiffness assessed using the WOMAC scale
• Physical function assessed using the WOMAC scale
• Physical function assessed using the Lequesne Functional Index (LFI)

A total of 712 adults (average ages of 52–62) with osteoarthritis.

A meta-analysis of 9 randomized controlled trials was performed. The intervention products studied included 5-Loxin® (a BS extract), Aflapin® (a combination of BS extract and Boswellia-specific non-volatile oil), Artrosulfur® (a combination of BS extract and methylsulfonylmethane), Curamin® (a combination of BS extract and curcumin), Boswellin® (a BS extract), and Lanconone® (a multiherbal formulation containing a BS extract). Most trials compared one of the aforementioned products to a placebo. However, 1 trial compared Aflapin® to 5-Loxin®, 1 trial compared Artrosulfur® to glucosamine sulfate, and 1 trial compared Curamin® to Curamed® (a curcumin product). The intervention duration ranged from 1 to 6 months.

Compared to the control, supplementation with products containing BS extract reduced pain on the VAS and WOMAC scales and stiffness on the WOMAC scale and increased physical function on the WOMAC and LFI scales.

In subgroup analyses comparing Aflapin® to other BS extracts, Aflapin improved all outcomes more than other BS extracts.

The risk of bias was low in 3 trials, unclear in 4 trials, and high in 2 trials.