Boswellia & Curcumin in Combination for Arthritis

The Arthritis Foundation recommends Boswellic acid as a treatment for rheumatoid arthritis and osteoarthritis. Boswellia has been clinically confirmed to contain antiarthritic, anti-inflammatory, pro-apoptotic, and pain-relieving pharmacological properties that can benefit IBD-related arthritis. 

Boswellia contains two active compounds, incensole acetate and incesole that inhibit NF-κB activity and IκBα degradation. Boswellia also suppresses interleukin-1 β, TNF-α & interferon-γ and enhances the production of IL-10, inhibiting proinflammatory cytokines that play a role in inflammation and tissue damage during the progression of rheumatoid arthritis. These are the same mechanisms of action targeted by biologics. 

Curcumin, the bioactive compound found in turmeric, is a potent natural anti-inflammatory and antioxidant agent. Curcumin reduces inflammation by suppressing the dysregulated NF-κB activity that triggers chronic inflammation. In addition, curcumin targets numerous inflammatory cytokines and has been found to help manage inflammatory conditions including osteoarthritis. 

Clinical trials have demonstrated the increased efficacy of combining curcumin and Boswellic acid for the treatment of osteoarthritis due to the synergistic effects of the two remedies. Both have been found to decrease NOand IL-6 production, two inflammatory mediators, and increase GDF15 production, an anti-inflammatory growth factor.  

Curcumin & Boswellia in Combination 

Efficacy and safety of curcumin and its combination with boswellic acid in osteoarthritis: a comparative, randomized, double-blind, placebo-controlled study

This 2018 trial observed the combination of curcumin and Boswellia in patients (aged 40 – 70) with osteoarthritis (OA). Participants took the combination three times a day for 12 weeks. Joint pain, morning stiffness, limited physical function, and disease severity were measured. The treatment was well tolerated, and the results were favorable compared to placebo. The researchers concluded that curcumin in combination with boswellic acid is more effective due to synergistic effects. 

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Clinical evaluation of a formulation containing Curcuma longa and Boswellia serrata extracts in the management of knee osteoarthritis

This trial evaluated curcumin and Boswellia for safety and efficacy in osteoarthritic patients, directly comparing the combination with celecoxib. Curcumin and Boswellia were found superior to celecoxib in improving pain scores, walking distance, joint line tenderness, range of joint movements, and crepitus. 

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Boswellia for Arthritis 

Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis

A 2020 meta-analysis in China assessed data from 7 randomized controlled trials to assess the effects of Boswellia on patients with OA against either placebo or western medicine. They found that compared to control groups, Boswellia “may relieve pain” and stiffness, and improve joint function. It was found a safe and effective treatment option for OA. 

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A pilot, randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee

In 2019, researchers tested the safety and efficacy of Boswellia serrata extract (BSE) on 48 patients with OA (knee allocated), who were administered either BSE or placebo for 120 days. BSE significantly improved physical function, and reduced pain and stiffness compared to placebo. There were also reduced serum levels of high-sensitive C-reactive protein, an inflammatory marker potentially associated with OA of the knee. There were no adverse effects. 

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Efficacy and tolerability of Boswellia serrata extract in the treatment of osteoarthritis of knee – A randomized double-blind placebo-controlled trial

Researchers observed 30 OA patients on either Boswellia or placebo for 8 weeks. All patients taking Boswellia reported a decrease in knee pain, increased knee flexion, and increased walking distance. The frequency of swelling also decreased. The differences between those treated with Boswellia and those on placebo were statistically significant and considered clinically relevant. BSE was recommended for patients with OA of the knee, with potential therapeutic use in other manifestations of arthritis. 

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 Efficacy and Safety of Aflapin®, a Novel Boswellia Serrata Extract, in the Treatment of Osteoarthritis of the Knee: A Short-Term 30-Day Randomized, Double-Blind, Placebo-Controlled Clinical Study 

This 2021 study observed the effects of Boswellia on 67 OA patients against placebo groups. Participants were evaluated for pain and physical function and had significant improvement in pain scores as early as five days into treatment. Boswellia was found clinically efficacious, fast-acting, and safe in the management of osteoarthritis.  

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Effect of Boswellia Serrata Extract on Acute Inflammatory Parameters and Tumor Necrosis Factor-α in Complete Freund’s Adjuvant-Induced Animal Model of Rheumatoid Arthritis 

Researchers tested Boswellia on rats with induced arthritis. They found significant improvements in body weight and a decrease in the arthritic index, an improvement comparable with Indomethacin. The study concluded that Boswellia may be useful as an adjunct to conventional therapy for RA. 

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Curcumin for Arthritis 

The efficacy of high- and low-dose curcumin in knee osteoarthritis: A systematic review and meta-analysis

This meta-analysis reviewed 11 randomized controlled trials with a total of 1258 participants who had OA of the knee. Both low and high doses of curcuminoids were found to have similar pain relief effects and were associated with better pain relief than non-steroid anti-inflammatory drugs.

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 A Randomized, Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis 

In 2012, researchers ran an open-label pilot study on 45 patients with rheumatoid arthritis (RA). After 8 weeks, the curcumin group showed the highest percentage of improvement. Based on the results, curcumin was found to have significant efficacy and was surprisingly more effective in alleviating pain compared with diclofenac. 

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Efficacy and safety of Curcuma domestica extracts in patients with knee osteoarthritis

This trial investigated the efficacy and safety of Curcuma domestica extracts in pain reduction and functional improvement in patients with knee osteoarthritis. 107 patients were randomized to receive ibuprofen or C. domestica extracts for 6 weeks. Curcuma was found to have similar efficacy and safety as ibuprofen for the treatment of knee OA.

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Curcuminoid Treatment for Knee Osteoarthritis: A Randomized Double-Blind Placebo-Controlled Trial

Researchers investigated curcuminoid treatment for mild to moderate OA. The results indicated that curcuminoid supplementation is effective in alleviating symptoms and ‘improving care’ of patients with mild to moderate OA. 

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