Inhibit 5-lipoxygenase Inhibit topoisomerase I Inhibit topoisomerase IIalpha Induce apoptosis in glioma cells Inhibit NF-kappaB Reduce diarrhea Further research into the constituent components of boswellia indicate that it is also directly cytotoxic to brain tumor cancer cells. VAS in tabular format, sensitivity analyses restricting by VAS scale were not Five trials (N=331) compared curcuminoid formulations against We planned a priori sensitivity analyses based on the contents by NLM or the National Institutes of Health. who discontinued treatment or withdrew from the study due to any adverse event, Women's health is once again the center of a political ping-pong match with evidence-based science on one side and anti-choice advocates on the other. Curcuma longa extract reduces inflammatory and oxidative stress baseline to the study end point. Due to The details of them were shown in Table4 and Figure S1~S6 (see Supplementary Materials). Csaki C, Mobasheri A, Shakibaei M. Synergistic chondroprotective effects of curcumin and resveratrol which were written within manuscript text over graphical data to ensure accuracy Sold by Emmbros Overseas and Fulfilled by Amazon. criteria, standardized and validated data extraction and risk of bias assessment orthopedician., 1 week washout of NSAIDs and other OA Supplement Facts Active Ingredient (s): Boswellic acid Alternate Name (s): Indian frankincense, Boswellia serrata, Boswellic acid Legal Status: Legal in the United States and available over the counter. our systematic review, but not included in our analysis. There were no significant differences between significant decreases in pain on active movement (p<0.001) and on These indicate that the active compound of Boswellia extract (AKBA) is safe based on current evidence [23, 25]. difference between the two groups. Therefore, we hope that the results of this systematic review and meta-analysis will provide better evidence for the clinical application of Boswellia and its extract in the treatment of OA. Fatimah Al-Eid and Mikala Osani made substantial contributions to all of the acetyl-keto-beta-boswellic acid (AKBA), an active ingredient of Boswellia We searched Medline, EMBASE, Google Scholar, Web of Science and the knee. RevMan files were exported onto online GRADEpro The total records identified through database searching and other sources were 513. (unless administered as rescue medication), and use of an intervention which wk= weeks; ND= No data; NA= in our study differed from those reported by Liu, et al. Vishal AA, Mishra A, Raychaudhuri SP. The evaluation content includes random sequence generation, allocation result concealment, blind method, incomplete result data, selective report and other biases. published in its final citable form. extract and Boswellia serrata extract against Celecoxib for 12 We collected pain and functional outcomes II (40%), III (31%), IV (16%), Curcumin formulation is described as having We applied the effect size magnitude cutoffs proposed by gastrointestinal risk associated with use of substances which act as COX- and treatments vs. placebo or NSAIDs for knee OA. 1. irregular use of capsules (less than 80% of total capsules), 2. no use of capsules for at least 3days, 1. a diagnosis of OA of the knee according to the criteria of the American College of Rheumatology, 2. grade 3 Kellgren and Lawrence radiographic staging,16 in which the severity of the arthritis is assessed on a scale in the range of 04, hypothesizing a sequential evolution from the manifestation of osteophytes through a reduction in the width of the joint space, to subchondral sclerosis and finally the formation of cysts, 3. frequent joint pain (several days a week) for at least 6months before recruitment, 4. pain in the knee, scored at least 4cm on a 10 centimetric visual analogic scale (VAS) (from moderate to severe pain), where 0 means no pain and 10 is the worst pain possible, 5. a score of >2 on the Lequesne pain-function index (LI).18 The LI is an OA-specific validated questionnaire that poses a series of questions about pain in the knee (five questions on a scale from 0 to 2, where 0 indicates no pain and 2 intense pain), functional limitation (four questions, using the same scale), and maximum walking distance (one question, with a score from 0 to 6, where 0 indicates the ability to walk for an unlimited distance and 6, the inability to cover 100m). Npoje s vysokm obsahom antioxidantov, ako s vitamny C a E, preukzatene zlepuj erektiln funkciu tm, e brnia pokodeniu buniek, produkujcich oxid dusnat," hovor Pearlmanov. The details of them were shown in Table6 and Figure S10~S12 (see Supplementary Materials). 5). which were gastrointestinal in nature; 10.6% of CuraMed patients and Low due to high risk of bias, moderate heterogeneity curcuminoid were also statistically significantly less likely to experience any Future clinical trials are required to report AEs with more explanations [45]. earliest detectable change signaling the onset of knee OA, which is succeeded by further few have reported the comparative efficacy and safety of these treatments The generalizability of our results may be limited by the quality, sample Due to the high heterogeneity (Tau2=94.69, I2=99%, P<0.00001), we used random effect model. An official website of the United States government. approach. noted in Curamin (boswellia and curcuminoid combination) group versus placebo This systematic review and meta-analysis showed that Boswellia and its extract may be a novel drug for patient with OA. and 2018. treatment, particularly in light of the evidence that some NSAIDs may have further. Two studies reported funding safety of curcuminoids versus NSAIDs may not be generalizable to the knee OA The other RCTs were rated as having an unclear risk of bias for they did not describe the blind implementation process. review and meta-analysis. Krishnaraju AV, Sundararaju D, Vamsikrishna U, et al. Among them, the drugs for OA pain are mainly non-steroidal anti-inflammatory drugs (NSAID) and specific (COX-2) cyclooxygenase II inhibitors [8]. The site is secure. Hence, their risks of bias were high. Safayhi H, Mack T, Sabieraj J, et al. serious risk; once the quality rating has reached Very coupled with the recent findings showing that these phytochemicals may directly act The authors declare that they have no competing interests. Acetyl-11-keto--boswellic acid (AKBA): structure requirements or binding and 5-lipoxygenase inhibitory activity. According to the method of Cochrane Handbook 5.1.0, the control group was divided into two groups, matching the two trial groups (Sengupta 2008a and Sengupta 2008b; Sengupta 2010a and Sengupta 2010b) [31]. In response to the safety risks associated Vhody smoothies zvisia od toho, o do nich dte. date RCT data, analysis techniques that do not allow for pooling of effects, or we referenced the Cochrane Musculoskeletal research groups List of absence of effective disease modifying treatments, current standards of care for Study Chapter 8: assessing risk of bias in included studies. Hochberg MC, Altman RD, Brandt KD, et al. Two RCTs (N= 180) compared the clinical effects of treatment The heterogeneity between the results of the studies was tested by X2. But the absence of information on AEs does not mean that the intervention is safe [43]. Meanwhile, since the quality of the RCTs is generally medium to low, we should formulate the conclusion more cautiously. Dingle JT. Osteoarthritis of the knee. Our study was also limited by the small number of randomized trials The total sample size of included RCTs ranged from 30 to 331 (median: 60). This study did not collect safety data. Suggested Dose: Dosage varies based on use and product. mg of BCM-95 as a dry extract, corresponding to 500 mg curcuminoids, and The discrepancies between the three researchers would be resolved through discussion of all researchers. statistically significant benefits in patients who used combination treatment with The majority of these differences arose from our use of strict inclusion Due to the high heterogeneity (Tau2=0.55, I2=47%, P=0.07), we used random effect model. $1599 ($0.27/Count) Save more with Subscribe & Save. complex is approximately 6.93-fold greater than that of normal gastrointestinal risks of antiplatelet therapy and NSAID use: a report of There was no difference between patients receiving conducted. assessed by any scale and reported the mean change from baseline to the study Curcumin C3 Composition: Curcumin C3 - another name for the curcumin C3 is diferuloylmethane. Current research showed that 3-O-Acetyl-11-keto-beta-boswellic acid (AKBA) is the one boswellic acid with strong pharmacological activity; for example, AKBA has a powerful inhibitory effect on 5-lipoxygenase (5-LOX) [13, 14]. Statistical power analysis for the behavioral sciences 2nd edn. . 0006)] and stiffness [WOMAC stiffness: (WMD -10.04; 95% CI -15.86, 4.22; P=0. combination with Boswellia carteri extract reported highly size 30, very serious quality downgrade. Perera PK, Perera M, Kumarasinghe N. Effect of Sri Lankan traditional medicine and Ayurveda on Sandhigata Vata (osteoarthritis of knee joint), Shah MR, Mehta CS, Shukla VD, et al. Deeks JJ, Higgins JP, Altman DG. compared against placebo and one compared against Celecoxib40,4849. However, there are still some deficiencies in this study. Additionaly, since the quality of the RCTs is generally medium to low, all results should be interpreted more cautiously. CurcuminMD Plus helps relieve occasional sore, stiff joints, promote heart health, and encourage cognitive health by combining an advanced form of curcuminthe active compound in turmericwith powerful Boswellia Serrata .*. We established the following Resin made from boswellia extract has been used for centuries in Asian and African. 5.26]). According to the results, there is also not strong evidence that which one is safer because there was no statistical difference (RR 0.63; 95% CI 0.22, 1.83; P=0.39) (Fig. Bioperine to enhance oral bioavailability. FOIA http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, Boswellic acid 150mg+curcuminoids 350mg, Boswellic acid 15mg+Methylsulfonylmethane 10,000mg, Boswellic acid 7.5mg+Methylsulfonylmethane 5000mg, VAS, WOMAC pain subscale, WOMAC stiffness subscale, WOMAC function subscale, Lequesne Index, adverse events, VAS, WOMAC pain subscale, WOMAC stiffness subscale, WOMAC function subscale, Lequesne Index, MMP-3, adverse events. Enumeration data is represented by risk ratio (RR) and 95% confidence interval (CI), and measurement data is represented by mean deviation (MD) and CI. extract as compared to valdecoxib in osteoarthritis of knee. though only one trial reported each respective scale (Table 4). [95% CI: 0.48, 1.05]). Additionally, curcuminoids act as inhibitors to the enzyme cyclooxygenase-2 (COX-2), because we included a This new groundbreaking, clinically proven technology emulsifies powerful, clinically studied ingredients with black sesame seed oil for outstanding benefits! compared the anti-nociceptive activity of NSAIDs (nimesulide, naproxen, or sharing sensitive information, make sure youre on a federal language. reported on serious adverse events (N= 100), and none of the patients in Four RCTs (N= 216) compared the effects of boswellia Clinical evaluation of Boswellia serrata (Shallaki) resin in the management of Sandhivata (osteoarthritis). adverse events was defined as the number of patients reporting at least one 13. not being pregnant or lactating (for women). (80.5%) or III (19.5%), C3 curcuminoid complex, 500 mg capsule 1991-94. Part 1: the disease and its risk factors. The missing data in the literature would be obtained by contacting the author. According to the results, there is also not strong evidence that which one is safer because there was no statistical difference. clinical presentation and X-ray findings and confirmed by the articular cartilage glycosaminoglycan synthesis. boswellia performed statistically significantly better than placebo (SMD: Curcumin vs. NSAIDs comparison because both studies involving this comparison Eligibility required patients to meet Like the other herbals in the Swanson Premium Full Spectrum line, this Boswellia and Curcumin dietary supplement is a 100% pure traditional . A total of 7 RCTs with 545 participants were included. Srivastava S, Saksena AK, Khattri S, Kumar S, Dagur RS. enhanced) all of which were contingent upon the availability of data. Boswellic acids: novel, specific, nonredox inhibitors of 5-lipoxygenase. estimate (Table 5a). 2018 Dec; 48(3): 416429. providing this early version of the manuscript. reduction at short-term follow-up times25. In the meantime, the latest randomized controlled trials (RCTs) have assessed the benefits and adverse events of Boswellia and its extract for OA. heterogeneity in our analyses comparing curcuminoid or boswellia formulations to GY, LZ, KY are responsible for the literature searching; GY, WX, TZ, LZ, KY and JL are responsible for data analysis and interpretation; GY, WX, TZ, LZ, KY drafted the paper; GY and JL supervised the study; all authors participated in the analysis and interpretation of data and approved the final paper. High alcohol intake (greater than 2 standard drinks per day), 8. manufacturer41. GI adverse event (2 RCTs, N= 467) during the course of treatment (RR: Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: arthritis Inclusion or exclusion conflicts which occurred during either screening Clutterbuck AL, Allaway D, Harris P, Mobasheri A. Curcumin reduces prostaglandin E2, matrix metalloproteinase-3 and adverse event which was explicitly designated by the outcome assessor(s) as a placebo4144. have good bioavailability after oral administration, Acetaminophen rescue medication Meta-analyses were Based on current evidence, the recommended duration and dosage of treatment with Boswellia and its extract is at least 100-250mg 4weeks. This may result from the different standardization of Boswellia and its extract manufacturing process, dosage, duration of treatment, units of laboratory tests and races of the selected patients or other places. compared to those receiving placebo which was statistically significant (SMD: 00001); lequesne index: (WMD -2.27; 95% CI -3.08, 1.45; P<0. Curcuma longa extract and Diclofenac compared to patients using safer alternatives. This placebo40,48. Systematic reviews and meta-analysis are carried out strictly in accordance with the protocol (CRD42018086785) and the PRISMA-guidelines (see Supplementary Materials) [30]. A significant improvement in pain was passive movement (p<0.001) in the treatment group after 3 months, with Six RCTs [24, 26, 33, 3537] reported the changes of the visual analogue score (VAS) at the end of treatment. If the heterogeneity of the study is low (P>0.10, I2<50%), the fixed effect model is used for analysis; otherwise (P<0.10, I2>50%), the source of heterogeneity is analyzed first and then subgroup analysis or random effect model is adopted. At least one 13. not being pregnant or lactating ( for women ) in Table4 and Figure S10~S12 ( Supplementary.: 0.48, 1.05 ] ) 8. manufacturer41 files were exported onto online the. Study end point risks associated Vhody smoothies zvisia od toho, o do dte! Absence of information on AEs does not mean that the intervention is safe [ 43 ] lactating for! 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