(P18-037-24) A Standardized Boswellia serrata Gum Extract Promotes Chondroprotection and Improves Knee Pain, Function, and Inflammation in Adults With Mild to Moderate Osteoarthritis

Objectives: The gum resin of the Boswellia serrata tree is known for its anti-inflammatory and analgesic properties. This 180-day randomized, double-blind, placebo-controlled trial evaluated the effects of supplementation with a standardized Boswellia extract composition, SN13108F, on pain, functional mobility, inflammation, and knee joint cartilage architecture compared to placebo.

Methods: Eighty (43M/37F) subjects, aged 40-75, with a BMI of 20-29 kg/m² and a grade II/III Kellgren-Lawrence, were randomized to either 100 mg of SN13108F (n=40, BSE) or a matched placebo capsule (n=40, PLA) daily for 180 days. Measures of joint pain, stiffness, and functional mobility were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale (VAS), Lequesne’s Functional Index (LFI), Six-Minute Walk Test (SMWT), and Stair Climb Test (SCT) at days 30, 60, 120, and 180. Knee joint space and cartilage thickness were assessed via magnetic resonance imaging (MRI) at baseline and day 180. Biomarkers, serum C-reactive protein (hs-CRP), matrix metalloproteinase (MMP-3), type II collagen degradation peptide (C2C), fibulin-3, and urinary C-terminal cross-linked telopeptides of type II collagen (uCTX-II) were also assessed.

Results: BSE supplementation improved pain, stiffness, and mobility. There was a significant (p < 0.001) group-time interaction effect for WOMAC, VAS, LFI, SMWT, and SCT, and a priori planned group comparisons demonstrated BSE significantly (p < 0.05) improved outcomes compared to PLA at days 30, 60, 120, and 180. All biomarkers, as well as MRI-assessed measures of joint space and cartilage thickness, improved with supplementation (group-time interaction effect p< 0.001). At day 180, BSE improved knee joint space compared to PLA (p < 0.001); BSE improved joint space over baseline by 1.5% (p < 0.001), whereas PLA decreased by 1.9% (p < 0.01). Likewise, each of the four MRI-measured knee articular cartilage compartments—lateral tibia, medial tibia, femoral, and patellar—significantly increased thickness compared to PLA (p < 0.01).

Conclusions: Six months of standardized boswellia extract supplementation mitigates joint pain and inflammation, improves mobility, and provides protective properties to knee joint cartilage in adults with mild to moderate OA.

Funding Sources: Sundyota Numandis Probioceuticals