Comparative Effectiveness of Nutritional Supplements in the Treatment of Knee Osteoarthritis

[DavidPS]

A recent network meta-analysis published in the journal Nutrients systematically compared the effectiveness of seven common nutritional supplements for treating knee osteoarthritis (KOA).

The analysis included 39 randomized controlled trials (RCTs) with a total of 4,599 patients. Researchers evaluated the impact of eggshell membrane, vitamin D, Boswellia, curcumin, ginger, krill oil, and collagen against a placebo for improving pain, stiffness, and function. The results showed that compared to a placebo, Boswellia provided statistically significant improvements across all measures, including WOMAC pain (mean difference [MD] = -10.58), stiffness (MD = -9.47), function (MD = -14.00), and VAS pain (MD = -17.26). Bayesian analysis consistently ranked Boswellia as the most likely to be the best option for pain and stiffness relief.

Other supplements also showed benefits; krill oil, curcumin, and collagen significantly improved function, while collagen, curcumin, and ginger significantly reduced VAS pain scores. Importantly, no supplement was associated with an increase in adverse events compared to the placebo.

Comparative Effectiveness of Nutritional Supplements in the Treatment of Knee Osteoarthritis: A Network Meta-Analysis (2025)

[LucH]

Hi,
In my research on the effects of phytotherapy against inflammation in order to relieve pain, I found this. Boswellic acid from boswellia serrata is effective against these “agents”:
Board:

So effective against these agents.
Abréviations:
RA = Rhumatisme arthritique / Rheumatoid Polyarthritis (often calle « PR », in French)
PGE = Prostaglandines.
IL-1B = cytokine, mediator involved in particular in RA (destruction of cartilage/synovium).
TNF-a = facteur de nécrose tumorale alpha (cytokine, messenger involved in the inflammatory process).
MMP = matrice métalloprotéinase (MMP stands for enzymes that selectively hydrolyze peptide bonds and degrade structural proteins; they play a crucial role in the breakdown of joint tissues).
NF-kB = facteur nucléaire-kappa B (controls many genes involved in inflammation).
PLA2 = Phospholipase A2.
NO = monoxyde d’azote synthase (=>inhibited nitric oxide production).
LPS = Lipo-polysaccharides (immune reaction induced by an excess of bacterial residues destroyed by macrophages).
AO = anti-oxydant.
(x) => (moderate effectiveness) (if into brackets)
X? => A single source found. NB: Unchecked boxes only indicate that I have not found any "reliable studies" mentioning this action. We will complete this later, if possible...

See this post, on my forum, for analyze and comments:

• Understanding the inflammatory response (AA cascade).
• Substances naturelles anti-douleur. Tableau
  https://mirzoune-ciboulette.forumactif.org/t266-substances-naturelles-anti-douleur-tableau#15733
  (update 04/2020) :
  Comment: I’d combine Boswellia with Celadrin to target as much possible the other factors. These molecules only acts on inflammation, not on the pain.
  Celadrin is a brand name and is made of “unsaponifiables”, often coming from of avocado and soy.
  Lubricates joints. 350 mg 3X/jr.
  Comment:
  Don’t forget these molecules have to be taken in staples, with recovery periods, not to weaken the detox pathway Cyp450 (accumulation of toxins could happen, otherwise). So pause every 6 weeks, according to your feelings, as well.
  Some substances have an impact on platelet aggregation, as well. E.g. curcumin and aspirin (white willow bark). Not Celadrin.
  The body is able to manage and fight against pain, if not overburden. Need to be covered against oxidation, to preserve homeostasis (interaction). B6 PLP could be useful too but mind the side effects when overload. I associate 100 mg of each B1, B2, B3 niacinamide, B6 PLP + 500 mg TMG, but only 5 days a week, for 3 weeks. Then 2 weeks stop (to avoid problem with GABA when excess B6).