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A novel boswellic acids delivery form (Casperome®) in the management of musculoskeletal disorders: a review.
Riva, A, Allegrini, P, Franceschi, F, Togni, S, Giacomelli, L, Eggenhoffner, R
European review for medical and pharmacological sciences. 2017;21(22):5258-5263
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Musculoskeletal conditions, including osteoarthritis, inflammatory arthritis, musculoskeletal injuries, gout and metabolic bone disease, are the most common cause of chronic disability worldwide. Treatment with analgesic and/or anti-inflammatory medication carries a significant risk of side effects. Botanical extracts are also commonly used for the management of musculoskeletal disorders, and in addition to having less side effects they may have a beneficial effect on the course of the disease. This review focuses on the use of boswellic acids (BA, from Frankincense, Boswellia serrata and Boswellia carterii) in the treatment of musculoskeletal conditions. In pre-clinical experiments, BAs have been shown to be anti-inflammatory and improve antioxidant status. In several clinical trials BSE was superior to placebo in reducing pain and increasing functionality in osteoarthritis. BSE are poorly absorbed, and both clinical and pre-clinical research has shown that a combination of BAs with lecithin (Casperome®) enhances absorption and bioavailability. Casperome® has been investigated in a number of clinical trials and has been shown to be of benefit in tendinopathies (inflammation of the elbow and Achilles tendon), radiculopathies (pinched nerves), sprained ankles and sports injuries. The authors conclude that Casperome® is a promising remedy as part of an integrated approach to musculoskeletal disorders.
Abstract
Standard pharmacological treatment of musculoskeletal conditions is often associated with relevant side effects. Botanical preparations endowed with a good tolerability profile, therefore, could have a role in the management of these disorders. Among different natural products, Boswellia serrata extracts have long been used for the treatment of musculoskeletal disorders, given their marked anti-inflammatory activity and their ability to promote tissue regeneration. However, standard preparations of Boswellia serrata show overall modest pharmacokinetic properties, a limitation which may ultimately lead to reduced efficacy. In an effort to improve the pharmacokinetic properties, Casperome®, a lecithin-based formulation of Boswellia serrata extract representing the whole natural bouquet, has been developed. This formulation was effective in the treatment of Achilles tendonitis, epicondylitis, radiculopathies, ankle sprains and sport injuries as shown in several clinical studies, the majority of which with a randomized design and all evaluating a number of well-recognized parameters of efficacy for the therapy of musculoskeletal disorder. All studies were consistent in showing a prompt decrease of pain and improvement of functionality of the affected area after supplementation with Casperome®, without any relevant adverse effect. Remarkably, these symptomatic improvements were paralleled by reduced plasmatic levels of inflammatory markers and by a diminished need for rescue analgesics. On these bases, Casperome® may have a role in the treatment of musculoskeletal disorders. Clinical studies in other similar conditions (e.g., osteoarthritis) appear warranted to further investigate the efficacy of this botanical product in more specific settings.