Abstract

BACKGROUND:

Osteoarthritis (OA) is a chronic degenerative joint disease characterized by cartilage destruction, inflammation, and progressive damage to joint. Although ibuprofen is widely used for OA management, its long-term use may be associated with adverse effects. Boswellia sacra possesses anti-inflammatory properties that may enhance the therapeutic efficacy of conventional treatment.

OBJECTIVES:

This study aimed to investigate the pharmacodynamic interaction between Boswellia sacra extract and ibuprofen in a rat model of monosodium iodoacetate (MIA)-induced osteoarthritis.

METHODS:

Thirty adult male albino rats (12 weeks old, 190-210 g) were randomly into allocated five groups (n=6): negative control (saline), positive control (MIA-precipitated OA), ibuprofen treated group (40 mg/kg/day), Boswellia sacra extract treated group (400 mg/kg/day), and a combination treated group receiving half doses of ibuprofen (20 mg/kg/day) and Boswellia sacra extract (200 mg/kg/day). Medications were administered orally for 21 consecutive days after OA induction. The anti-inflammatory effects were evaluated by measuring the serum levels of interleukin-1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) as well as cyclooxygenase-2 (PTGS2/COX-2) gene expression in kidney samples.

RESULTS:

Administration of ibuprofen, Boswellia sacra extract and their combination significantly reduced IL-1β from 32.7 ± 1.12 to 23.4 ± 0.99 pg/mL and TNF-α from 123.2 ± 2.05 to 91.1 ± 4.80 pg/mL (P < 0.0001) and COX-2 expression levels. These results indicate that Boswellia sacra extracts have anti-inflammatory effects and can enhance the therapeutic efficacy of ibuprofen through pharmacodynamic interactions. The combination treatment produced marked anti-inflammatory effects while using lower doses of both agents.

CONCLUSIONS:

The findings suggest that combination therapy by half doses of ibuprofen and Boswellia sacra extract can achieve comparable anti-inflammatory outcomes along with potential reduction of the adverse effects associated with long-term NSAID use. Therefore, this approach may represent a promising medication for osteoarthritis management