'Wise men' ingredients for joint health

It's December — when joints creak from the cold and tales swirl of three wise men delivering tidings of joy. So yeah, let's talk frankincense (Boswellia serrata). A December 2008 review published in the British Medical Journal assayed randomised clinical trials related to osteoarthritis (as well as asthma and colitis). The reviewer found frankincense evidence to be "encouraging but not compelling" in treating conditions caused or maintained by inflammatory processes, along with no serious safety issues.¹ In particular, it cited a 2003 double-blind, placebo-controlled, crossover study conducted in India for eight weeks. Those receiving the frankincense extract reported decreased knee pain, increased knee flexion and increased walking distance, along with a decrease in frequency of swelling in the knee joint.²

But that's Old Testament frankincense. In the 21st century, Laila Nutraceuticals created a unique extraction process that standardises a frankincense extract to 30 per cent of what's seen as the most potent anti-inflammatory boswellic acid, AKBA. The result is a branded ingredient called 5-Loxin — so named for its ability to inhibit the 5-lipoxygenase enzyme, the enzyme that triggers the inflammatory response and breaks down protective joint tissues by ultimately producing pro-inflammatory leukotrienes. PL Thomas supplies the ingredient.

In 1997, Rexall Sundown launched the joint-health supplement formulation Osteo Bi-Flex. The glucosamine/chondroitin formulation quickly became one of the more successful product launches, and by 2004, it was the 34th-leading OTC product in America, and No. 1-selling joint-health supplement, according to Drug Store News, with sales north of $33 million and 10 per cent annual growth.

Not one to rest on its laurels, in 2006, Osteo Bi-Flex included the latest 'new and improved' joint-health ingredient: 5-Loxin. Its instincts were wise indeed, as a 2008 published study validated 5-Loxin's efficacy as an anti-inflammatory.

In the double-blind, randomised, placebo-controlled study, conducted in India, researchers gave 75 osteoarthritis patients either 100mg or 250mg 5-Loxin for 90 days. Both doses conferred clinically and statistically significant improvements in pain scores and physical function scores, though the 250mg dose was a bit more effective. Researchers noted improvements in as early as seven days for the 250mg group. They noted the ingredient worked not only by controlling pro-inflammatory modulators but also by reducing the enzymatic degradation of cartilage.³

"While a new ingredient, it is steeped in the historic roots of the Boswellia serrata plant, used in traditional Indian medicine for centuries," says Golakoti Trimurtulu, PhD, vice president of Laila Nutraceuticals. "Thus, 5-Loxin is the modern approach to tradition and history of Indian herbal therapy, being clinically proven for its effectiveness."

Researchers in India went so far as to put a Boswellia serrata extract in a head-to-head comparison study against valdexocib, a selective COX-2 inhibitor. The study was a six-month, randomised, prospective, open-label, comparative study in 66 patients with osteoarthritis of the knee. Researchers found that patients taking the boswellia extract showed statistically significant improvements with pain, stiffness and difficulty in performing daily activities after two months of taking the extract, with results that persisted for a month after the therapy was stopped.

The COX-2 inhibitor group, meanwhile, also experienced significant results in all parameters, with results occurring after only one month, but the results waned rapidly immediately after stopping the treatment.⁴