Evidence Level
Boswellia serrata has been extensively studied for its efficacy in managing knee osteoarthritis (OA). A 2020 meta-analysis by Yu et al. involving seven randomized controlled trials (RCTs) and 545 participants demonstrated significant improvements in pain and physical function among OA patients treated with Boswellia or its extracts. The patented Aflapin extract has been particularly noted for rapid results, with notable improvements observed within 5-7 days, as reported by Sengupta et al. (2010). Mechanistically, the active compound AKBA inhibits 5-lipoxygenase, thereby reducing pro-inflammatory mediators such as leukotriene B4.
Recent studies have further corroborated these findings. A systematic review and meta-analysis by Dubey et al. (2024) analyzed nine RCTs involving 712 participants, confirming that Boswellia serrata extract significantly reduces pain, stiffness, and functional limitations in OA patients. The AflapinⓇ extract was found to be more efficacious than other extracts. Additionally, a study by Inprasit et al. (2026) evaluated the efficacy of Boswellia serrata alongside Curcuma longa in treating knee OA across 20 RCTs involving 1633 participants, concluding that Boswellia improved joint function while Curcuma reduced pain, with no significant adverse events reported.
Boswellia is also notable for its gastrointestinal safety profile compared to NSAIDs, making it a promising alternative for long-term management of inflammatory conditions. Early research suggests potential benefits for inflammatory bowel disease and asthma, though further studies are needed to confirm these findings.