“If your patients suffer from rheumatoid arthritis, there is good news: A specialized extract of Boswellia serrata featuring high levels of its key compound, AKBA, has been shown to be incredibly well-absorbed, and effective in stopping inflammation and reducing symptoms. Plus, it prevents liver toxicity from prescription medication.”

THE STUDY ABSTRACT: Bioavailability, anti-inflammatory & anti-arthritic effect of acetyl keto boswellic acid & its combination with methotrexate in an arthritic animal model.

Banji D, Bandi OJ, Rashida S, Alshaharani S, Alqahtani SS. J Ethnopharmacol. 2022;292:115200.

Ethnopharmacological relevance: Rheumatoid arthritis is one of the most common disabling chronic progressive autoimmune diseases affecting the adult world population. Boswellia serrata has been a known anti-inflammatory agent since ancient times. Therefore, research on boswellia extract based on acetyl keto boswellic acid (AKBA) content evaluating its efficacy and safety is necessary. The study aimed to find a suitable boswellia extract rich in AKBA to evaluate its bioavailability, anti-inflammatory, and anti-arthritic effect. In addition, the synergistic action of AKBA extract with methotrexate (MTX) was also assessed on an animal model.

Materials and methods: Oral bioavailability of AKBA and the anti-inflammatory activity of 10% AKBA (5, 10, 20, 40 mg/kg b.w) was assessed and compared with 2% AKBA (40 mg/kg) and diclofenac (10 mg/kg). The effect of 10% AKBA at 20 mg/kg and 40 mg/kg was evaluated in the FCA induced arthritis animal model alone and combined with methotrexate (MTX) at 2 mg/kg b.w. Subplantar injection of FCA produced edema within a few hours with progressive arthritis by the 9th day after injection. All the treatments were initiated from the 10th day until the 45th day. Oral administration of 10% AKBA was done daily and MTX by intraperitoneal route once a week from day 10 to day 45. Paw volume, erythrocyte sedimentation rate (ESR), serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), alkaline phosphatase (ALP), total bilirubin, oxidative markers (superoxide dismutase (SOD) levels, malondialdehyde (MDA), total proteins and liver histopathology were examined.

Results: 10% AKBA provided 8.48-fold, 24.22-fold, 47.36-fold, and 110.53-fold higher AUC (0-α) of AKBA at 5 mg/kg, 10 mg/kg, 20 mg/kg and 40 mg/kg, respectively compared to 2% AKBA at 40 mg/kg. Percentage paw edema inhibition of 10% AKBA at 20 mg/kg and 40 mg/kg were significantly higher than 2% regular AKBA (40 mg/kg) and diclofenac (10 mg/kg). 10% AKBA at a dose of 20 and 40 mg/kg significantly reduced ESR compared with FCA treated group. A combination of methotrexate with 10% AKBA showed the highest reduction in ESR. 10% AKBA at both dose levels significantly reduced hepatic marker enzymes and total bilirubin levels. Treatment with 10% AKBA showed a significant increase in total proteins, antioxidant enzymes and a decrease in malondialdehyde levels. Similarly, 10% AKBA protected the hepatocytes compared with the FCA and FCA + MTX treated group. 10% AKBA was capable of significantly minimizing FCA and FCA + MTX induced changes.

Conclusion: Anti-inflammatory activity of AKBA due to inhibition of lipoxygenase (LOX) enzymes supports the use of AKBA in inflammatory disorders. Combination therapy of 10% AKBA with MTX is effective in inhibiting arthritis and circumventing hepatotoxicity produced by MTX in arthritic animals.

WHAT THIS MEANS FOR PATIENTS

This research shows the incredible potential of a specialized boswellia extract for fighting rheumatoid arthritis, a condition conventionally treated with drugs known to cause liver or intestinal damage.

There are many impressive numbers reported in this study. First, is that a specialized boswellia extract showed 110 times the absorption of AKBA, the herb’s key anti-inflammatory compound, versus a standard low potency, 2% AKBA boswellia.

Beyond the absorption capacity, the specialized boswellia also reduced inflammation at higher levels at smaller dosages. For example, just 5 mg of specialized 10% AKBA boswellia reduced inflammation by 44%, while it took 40 mg of the 2% AKBA boswellia to achieve similar results. And comparing the same dosage levels, at 40 mg, the specialized 10% AKBA boswellia reduced inflammation by 75%.

This animal test also found that the 10% AKBA boswellia equaled the strength of a conventional drug, methotrexate, with each one reducing inflammatory symptoms by about 50%. When combined, the two treatments reduced inflammation by 63%. Not only did the specialized boswellia improve the effectiveness of methotrexate, it also protected the liver from toxic effects of the drug.

Overall, this specialized boswellia with 10% AKBA is better absorbed than common extracts, delivers more anti-inflammatory results, is equally effective as a prescription drug for rheumatoid arthritis, and can be used alongside those drugs and make them more effective and less harmful.

This is great news for anyone who suffers from rheumatoid arthritis. It is very likely that in the future this specialized boswellia may be used as a first line of treatment to effectively relieve the pain and joint damage of this terrible disease.