the current (perhaps whimsical- seasonal fayre) BMJ review of frankincense – boswellia – by Prof Ernst concludes: “Out of 47, three studies were of good methodological quality.. The evidence for the effectiveness of B serrata extracts is encouraging but not compelling”. It is thus hardly an advertorial for boswella or it’s extracts, as patentholders of extracts would wish…
In published trials the past decade, boswellia gives anti-inflammatory (pain and stiffness) benefits in arthritis and in colitis and asthma.
But only one trial of boswellia or an extract (Sengupta 2008) apparently mentions cartilage- and that one is only a 90 day study, did not measure cartilage width change by any method – ie it measured simply symptom response as to an anti-inflammatory. The clinical significance if any of the halving of matrix metalloprotein 3 MMP3 levels in synovial fluid is uncertain. This trial shows short term benefits compared to placebo -but even on placebo there was significant steady improvement in symptoms over three months. As this trial shows, the natural history of pain in recent-onset “osteoarthritis” (whatever pathology that umbrella covers) is spontaneous improvement anyway.
But the gold standard question for osteoarthritis OA is, does anything reverse cartilage loss, rebuild the worn cartilage, as opposed to merely masking cartilage destruction by supressing symptoms? Only chondroglucosamine CGA unquestionably does so if taken permanently for more than about 3 months. So CGA is the gold standard – see previous reviews below. .
This crucial issue – reversal of cartilage loss- seems to have been ignored so far for boswellia, since there are no more than short term trials (up to 3 months) in the literature.
Unlike the dire hazards of aspirin and synthetic nonsteroidal NSAIDs, we see excellent analgesic benefits and minimal adverse symptoms for eg arthritis with some appropriate safe combination of fish oil, boswellia, MSM, curcumin, cats claw, proline, nicotinamide, arnica and bromelain;
but is it ethical, or negligent, to treat deadly disabling arthritis with Christmas jocularity just with analgesics, without remittive agents eg CGA for OA, or for rheumatoid arthritis combination of eg methotrexate, prednisone chloroquine gold and salazopyrin ?
Its like sex and religion: Some can take religious tolerance, sex and freedom from disability for granted. The painless fun bit is usually too easy while it lasts. But like painful joints and religious intolerance, sex becomes serious eg when fun or fertility is lost, or infection or unplanned pregnancy occurs- or we are treated as criminal deviants if we prefer same-sex intercourse in countries with intolerant churchmen or leaders, like South Africa and Zimbabwe. Dismissing painful arthritis or painful sex with painkillers (and the two are often related) may be as dangerous because it may miss the window of opportunity for cure.