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Efficacy of Extracts of Oleogum Resin of Boswellia in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis.

作者信息

Dalmonte Thomas, Andreani Giulia, Rudelli Cecilia, Isani Gloria

机构信息

Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy.

出版信息

Phytother Res. 2024 Dec;38(12):5672-5689. doi: 10.1002/ptr.8336. Epub 2024 Sep 23.


DOI:10.1002/ptr.8336
PMID:39314013
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11634824/
Abstract

Knee osteoarthritis (OA) has recently been ranked as the 11th highest contributor to global disability. More than 40% of patients use complementary and alternative medicine including supplements containing phytoextracts with anti-inflammatory properties as those from the Boswellia genus. The aim of this meta-analysis was to evaluate the efficacy of phytoextracts from the oleogum resin of the Boswellia genus as supplementation for patients affected by knee OA. Four electronic databases were used for the research and PRISMA statements were followed throughout the study. The following inclusion criteria were used: (a) the subjects of the study were humans with a diagnosis of knee OA reported by medical staff; (b) randomization and the presence of control (placebo, negative or positive control), and (c) outcomes reported with WOMAC and/or visual analog scale (VAS) score. Publication bias was assessed with a funnel plot and through the Egger test. The Jadad scale was used in order to assess the quality of the studies included. The statistical heterogeneity was assessed using I statistics. Results of meta-analysis and subgroup analysis were reported using a forest plot. A total of 13 studies involving 850 (WOMAC) and 1185 (VAS) patients met the inclusion criteria. The meta-analysis did not detect a significant effect of the use of Boswellia extracts between the control and the treatment groups due to the high heterogeneity of the studies (p = 0.0865 for WOMAC) and (p = 0.3966 VAS). However, the subsequent subgroup analysis demonstrated the significant beneficial effect of Boswellia extracts in the treatment of knee OA with respect to a placebo (lower WOMAC score in the treatment groups). This was also confirmed in the meta-regression applied to the WOMAC scores. This is an important finding as people exposed to NSAID-related adverse effects could benefit from the use of Boswellia extracts. However, further high-quality studies are needed to establish the clinical efficacy of extracts from the genus Boswellia.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/a7eb60934047/PTR-38-5672-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/6deaa31223a9/PTR-38-5672-g013.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/110554686470/PTR-38-5672-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/a57cde17c030/PTR-38-5672-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/cd24d0845d97/PTR-38-5672-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/9dd3c1ff9ee4/PTR-38-5672-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/7208db50b536/PTR-38-5672-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/da7f73cafb7f/PTR-38-5672-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/db3d56e58fe6/PTR-38-5672-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/2fca90656945/PTR-38-5672-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/d606010be1e3/PTR-38-5672-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/01252a789888/PTR-38-5672-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/f12ce86fae16/PTR-38-5672-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/a7eb60934047/PTR-38-5672-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/6deaa31223a9/PTR-38-5672-g013.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/110554686470/PTR-38-5672-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/a57cde17c030/PTR-38-5672-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/cd24d0845d97/PTR-38-5672-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/9dd3c1ff9ee4/PTR-38-5672-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/7208db50b536/PTR-38-5672-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/da7f73cafb7f/PTR-38-5672-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/db3d56e58fe6/PTR-38-5672-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/2fca90656945/PTR-38-5672-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/d606010be1e3/PTR-38-5672-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/01252a789888/PTR-38-5672-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/f12ce86fae16/PTR-38-5672-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf66/11634824/a7eb60934047/PTR-38-5672-g001.jpg

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引用本文的文献

[1]
Comparative Effectiveness of Nutritional Supplements in the Treatment of Knee Osteoarthritis: A Network Meta-Analysis.

Nutrients. 2025-8-3

[2]
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J Nanobiotechnology. 2025-5-22

本文引用的文献

[1]
Interventions for osteoarthritis pain: A systematic review with network meta-analysis of existing Cochrane reviews.

Osteoarthr Cartil Open. 2022-2-15

[2]
Efficacy and Safety of Aflapin®, a Novel Extract, in the Treatment of Osteoarthritis of the Knee: A Short-Term 30-Day Randomized, Double-Blind, Placebo-Controlled Clinical Study.

J Am Nutr Assoc. 2023-2

[3]
The Role of Medicinal and Aromatic Plants against Obesity and Arthritis: A Review.

Nutrients. 2022-2-25

[4]
Safety assessment of a novel water-soluble extract of gum resin: acute toxicity, 90-day sub-chronic toxicity, Ames' bacterial reverse mutation, and micronucleus assays.

Toxicol Mech Methods. 2022-6

[5]
Nutraceutical Approach to Chronic Osteoarthritis: From Molecular Research to Clinical Evidence.

Int J Mol Sci. 2021-11-29

[6]
Use of Complementary and Alternative Therapy for Knee Osteoarthritis: Race and Gender Variations.

ACR Open Rheumatol. 2021-9

[7]
Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019.

Lancet. 2021-12-19

[8]
Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis.

BMC Complement Med Ther. 2020-7-17

[9]
Anti-inflammatory and anti-cancer activities of frankincense: Targets, treatments and toxicities.

Semin Cancer Biol. 2022-5

[10]
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BMJ. 2019-8-28

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