Two boswellia extracts compared with placebo over 90 days

What they did

Sixty people with knee osteoarthritis were randomised to 100 mg a day of 5-Loxin (20 people), 100 mg a day of Aflapin (20) or placebo (20) for 90 days. Both are extracts of Boswellia serrata gum resin. Pain and function were scored at the start and at days 7, 30, 60 and 90 with standard tools (visual analogue scale, Lequesne's Functional Index and WOMAC). Blood, urine and haematology tests checked safety. Separate lab studies looked at Aflapin's effect on MMP-3 and on ICAM-1, a molecule involved in inflammation.

What they found

Fifty-seven people completed the study. Both extracts produced clinically and statistically significant improvements in pain and physical function scores. In the Aflapin group, significant improvements appeared as early as day 7, and the authors report Aflapin worked better than 5-Loxin. In the lab, Aflapin inhibited MMP-3 and ICAM-1. Safety measures were almost unchanged compared with placebo.

What it can't tell us

Twenty people per group is small, and 90 days is short. The trial measured symptoms, not cartilage, and the MMP-3 result came from lab tests, not from the participants. MMP13 was not measured. The results belong to these two extracts at 100 mg a day, not to boswellia as a whole.

Why it matters

It adds a second placebo-controlled trial of boswellia extracts and a lab link to a matrix metalloproteinase, MMP-3. It also shows two extracts from the same resin, at the same dose, did not perform identically, which is a reason not to treat boswellia as one interchangeable ingredient.

The paper

1. Sengupta K, Krishnaraju AV, Vishal AA et al. Comparative efficacy and tolerability of 5-Loxin and Aflapin Against osteoarthritis of the knee: a double blind, randomized, placebo controlled clinical study. Int J Med Sci 2010.
   PMID 21060724DOI 10.7150/ijms.7.366

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