Evaluating the efficacy and safety of Curcuma longa, Boswellia serrata, and their mixed formulation in treating knee osteoarthritis: A systematic review and network meta-analysis

source extracted confidence: high 2026-04-09
#humans #boswellia #curcuma #osteoarthritis-knee #phytotherapy

Evaluating the efficacy and safety of Curcuma longa, Boswellia serrata, and their mixed formulation in treating knee osteoarthritis: A systematic review and network meta-analysis

Inprasit et al., 2026 | Complement Ther Med | Systematic Review

Citation

Inprasit Chanya, Bunyamahote Siriwadee, ... Dhippayom Teerapon. Evaluating the efficacy and safety of Curcuma longa, Boswellia serrata, and their mixed formulation in treating knee osteoarthritis: A systematic review and network meta-analysis. Complement Ther Med. 2026-Mar;96:103256. doi:10.1016/j.ctim.2025.103256

Abstract

BACKGROUND: Herbal interventions such as Curcuma longa (CL) and Boswellia serrata (BS) have demonstrated efficacy and safety in managing knee osteoarthritis (KOA); however, the effects of their combined formulation, including both direct and indirect outcomes, remain insufficiently explored. We performed systematic review and network meta-analysis for clinical effects of CL, BS, and their mixed formulation in alleviating KOA symptoms. METHODS: The CENTRAL, PubMed, EMBASE, and EBSCO Open Dissertations, databases and also from Snowballing and citation searching were searched through March 2025. The randomized controlled trials (RCTs) that studied effectiveness of CL or BS in KOA participants using Visual Analog Scale (VAS) and KOA severity by the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and adverse events as the main outcomes, were eligibly included. The Cochrane Risk of Bias a random-effects model, standardized mean differences (SMDs) along with 95 % confidence intervals (CIs) were employed. RESULTS: In total, 20 RCTs comprising 1633 participants were included. The modified formulations of CL showed a significant reduction in VAS compared to placebo (SMD: -2.82; 95 %CI: -5.30 to -0.33), while the modified formulations of BS demonstrated significant improvement in WOMAC pain, stiffness, and knee function compared to other intervention groups. No significant differences in adverse events were observed among all comparisons. CONCLUSIONS: BS extract, particularly in modified formulations, improves joint function in patients with mild to moderate KOA, while only the modified formulation of CL demonstrates notable pain-reducing efficacy. The potential benefits of combined CL and BS preparations warrant further investigation.

Key Findings

In total, 20 RCTs comprising 1633 participants were included. The modified formulations of CL showed a significant reduction in VAS compared to placebo (SMD: -2.82; 95 %CI: -5.30 to -0.33), while the modified formulations of BS demonstrated significant improvement in WOMAC pain, stiffness, and knee function compared to other intervention groups. No significant differences in adverse events were observed among all comparisons.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population mild to moderate koa
Sample Size 1633
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Boswellia
  • Curcuma
  • Osteoarthritis, Knee
  • Phytotherapy
  • Plant Extracts
  • Randomized Controlled Trials as Topic

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Network Meta-Analysis, Systematic Review
  • Vertical: boswellia

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09