{"title":"Efficacy evaluation of standardized Boswellia serrata extract (AflapinⓇ) in osteoarthritis: A systematic review and sub-group meta-analysis study","authors":"Vishal Dubey, Dharmeshkumar Kheni, Varun Sureja","doi":"10.1016/j.explore.2024.02.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and purpose</h3><p>Osteoarthritis (OA) is a joint disease characterized by pain, inflammation, and physical disability. <em>Boswellia serrata</em> (BS) is widely studied for its effectiveness in OA condition. Our systematic review and meta-analysis study was aimed to evaluate BS extract efficacy in OA. A sub-group analysis was performed to compare the efficacy of a standardized BS extract (Aflapin<sup>Ⓡ</sup>) with other BS extracts.</p></div><div><h3>Methods</h3><p>Randomized controlled trials, identified from three online databases, evaluating the effect of BS extracts in OA were included. Quality of studies was assessed using PEDro scale and risk of bias was assessed using Cochrane Risk of Bias tool. Pooled effect was reported as mean difference (MD) and 95% confidence interval. Study was conducted as per the Cochrane guidelines (PROSPERO registration ID: CRD42023411356).</p></div><div><h3>Results</h3><p>Nine RCTs with 712 participants were included. All studies (except one) were good quality studies. BS supplementation significantly reduced VAS (MD: -10.71; p<0.00001), LFI (MD: -2.99; p<0.00001), WOMAC-pain (MD: -10.69; p<0.0001), WOMAC-stiffness (MD: -5.49; p<0.00001), and WOMAC-function (MD: -10.69; p<0.00001) scores compared to control therapy. By sub-group analysis, Aflapin<sup>Ⓡ</sup> supplementation showed greater reduction in VAS (MD: -16.09 vs -4.68), LFI (MD: -3.81 vs -2.01), WOMAC-pain (MD: -18.68 vs -7.07), WOMAC-stiffness (MD: -14.25 vs -3.78), and WOMAC-function (MD: -14.99 vs -8.41) scores as compared to other BS therapies.</p></div><div><h3>Conclusions</h3><p>BS supplementation is effective OA symptomatic management. Sub-group analysis revealed that Aflapin<sup>Ⓡ</sup> supplementation may be better in improving the symptoms of OA which needs to be confirmed by more comparative clinical studies.</p></div>","PeriodicalId":50459,"journal":{"name":"Explore-The Journal of Science and Healing","volume":"20 5","pages":"Article 102983"},"PeriodicalIF":1.9000,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Explore-The Journal of Science and Healing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1550830724000090","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INTEGRATIVE & COMPLEMENTARY MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Background and purpose
Osteoarthritis (OA) is a joint disease characterized by pain, inflammation, and physical disability. Boswellia serrata (BS) is widely studied for its effectiveness in OA condition. Our systematic review and meta-analysis study was aimed to evaluate BS extract efficacy in OA. A sub-group analysis was performed to compare the efficacy of a standardized BS extract (AflapinⓇ) with other BS extracts.
Methods
Randomized controlled trials, identified from three online databases, evaluating the effect of BS extracts in OA were included. Quality of studies was assessed using PEDro scale and risk of bias was assessed using Cochrane Risk of Bias tool. Pooled effect was reported as mean difference (MD) and 95% confidence interval. Study was conducted as per the Cochrane guidelines (PROSPERO registration ID: CRD42023411356).
Results
Nine RCTs with 712 participants were included. All studies (except one) were good quality studies. BS supplementation significantly reduced VAS (MD: -10.71; p<0.00001), LFI (MD: -2.99; p<0.00001), WOMAC-pain (MD: -10.69; p<0.0001), WOMAC-stiffness (MD: -5.49; p<0.00001), and WOMAC-function (MD: -10.69; p<0.00001) scores compared to control therapy. By sub-group analysis, AflapinⓇ supplementation showed greater reduction in VAS (MD: -16.09 vs -4.68), LFI (MD: -3.81 vs -2.01), WOMAC-pain (MD: -18.68 vs -7.07), WOMAC-stiffness (MD: -14.25 vs -3.78), and WOMAC-function (MD: -14.99 vs -8.41) scores as compared to other BS therapies.
Conclusions
BS supplementation is effective OA symptomatic management. Sub-group analysis revealed that AflapinⓇ supplementation may be better in improving the symptoms of OA which needs to be confirmed by more comparative clinical studies.
背景和目的:骨关节炎(OA)是一种以疼痛、炎症和身体残疾为特征的关节疾病。乳香(BS)因其对骨关节炎的疗效而被广泛研究。我们的系统回顾和荟萃分析研究旨在评估乳香提取物对 OA 的疗效。我们还进行了分组分析,以比较标准化 BS 提取物(AflapinⓇ)与其他 BS 提取物的疗效:方法:纳入了从三个在线数据库中找到的评估 BS 提取物对 OA 效果的随机对照试验。研究质量采用 PEDro 量表进行评估,偏倚风险采用 Cochrane 偏倚风险工具进行评估。汇总效应以平均差(MD)和 95% 置信区间进行报告。研究按照 Cochrane 指南(PROSPERO 注册编号:CRD42023411356)进行:结果:共纳入 9 项研究,712 人参与。所有研究(一项除外)均为高质量研究。与其他 BS 疗法相比,补充 BS 可明显降低 VAS(MD:-10.71;pⓇ)、LFI(MD:-3.81 vs -2.01)、WOMAC-疼痛(MD:-18.68 vs -7.07)、WOMAC-僵硬(MD:-14.25 vs -3.78)和 WOMAC-功能(MD:-14.99 vs -8.41)评分:结论:补充 BS 可有效治疗 OA 症状。亚组分析显示,阿弗拉平Ⓡ补充剂在改善 OA 症状方面可能更好,这需要更多的临床对比研究来证实。
期刊介绍:
EXPLORE: The Journal of Science & Healing addresses the scientific principles behind, and applications of, evidence-based healing practices from a wide variety of sources, including conventional, alternative, and cross-cultural medicine. It is an interdisciplinary journal that explores the healing arts, consciousness, spirituality, eco-environmental issues, and basic science as all these fields relate to health.