Boswellia Serrata Clinical Evidence

Phytomedicine
Kinmatkar N, et al. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee—a randomized double blind placebo controlled trial. 2003 Jan;10(1):3-7. 

Topic: 
Can Boswellia serrata extract help patients with osteoarthritis of the knee?

Background:
The Boswellia serrata tree grows in India. Its gum has been found to have anti-inflammatory properties and to function as a painkiller. While boswellia has long been used as a natural treatment for arthritis, few well-controlled clinical trials have been undertaken.

Study Type:
Human clinical intervention trial

Study Design:
Randomized, double-blind, placebo-controlled crossover study. Patients were divided into two groups, one receiving boswellia serrata extract (BSE), standardized to 45% boswellic acids, and the other receiving placebo. After a washout period, the groups were switched, so all participants tried both treatments.

Subjects:
30 patients with osteoarthritis of the knee

Dosage:
333 mg/3 times a day, for 8 weeks

Results:
Patients taking the BSE experienced a decrease in knee pain and frequency of knee swelling. Additionally, they experienced an increase in knee flexibility and were able to walk longer distances. All of these differences were statistically significant. BSE was well tolerated, with only minor side effects.

Conclusion:
BSE is recommended in the patients of osteoarthritis of the knee with possible therapeutic use in other arthritis.”

Arthritis Research and Therapy 
Sengupta K et al. A double blind, randomized, placebo-controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee. 2008;10(4):R85. 

Topic: 
Is a standardized extract of Boswellia serrata (30% AKBA) a safe and effective treatment for osteoarthritis of the knee?

Background:
Boswellia serrata extract has been found to be an effective treatment for osteoarthritis of the knee in previous research. 5-Loxin is an extract of Boswellia standardized to contain 30% AKBA, considered the active constituent. How does it perform in osteoarthritis patients?

Study Type:
Human clinical intervention trial

Study Design:
Double-blind, randomized, placebo-controlled. Subjects took either standardized Boswellia serrata extract or placebo. Their pain and physical function were measured using the visual analog scale, Lequesne’s Functional Index, and the WOMAC Osteoarthritis Index at baseline, 7, 30, 60 and 90 days. Finally, the cartilage-degrading enzyme matrix metalloproteinase-3 was measured in their synovial fluid (fluid that serves as a lubricant within a joint).

Subjects:
75 osteoarthritis patients, 70 completed

Dosage:
100 or 250 mg/day for 90 days

Results:
Treatment was safe, with almost no side effects. Subjects taking the standardized Boswellia serrata extract at both doses experienced statistically significant improvements in both pain and physical function. Those taking the higher dose enjoyed these benefits as early as a week into the treatment. In both treatment groups there was a statistically significant decrease in synovial fluid matrix metalloproteinase-3.

Conclusion:
5-Loxin reduces pain and improves physical functioning significantly in OA patients; and it is safe for human consumption. 5-Loxin may exert its beneficial effects by controlling inflammatory responses through reducing proinflammatory modulators, and it may improve joint health by reducing the enzymatic degradation of cartilage in OA patients.

 

 

Boswellia Serrata Mechanism of Action

Boswellia extract decreases inflammatory pathways, reduces pro-inflammatory mediators, and reduces levels of matrix protein-degrading enzymes in the synovial fluid in the joints, thus reducing damage to cartilage in patients with osteoarthritis. These actions reduce pain and swelling while increasing flexibility and walking distance.