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
Bibliographic record
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.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.010 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".