title: The effectiveness of Commiphora mukul for osteoarthritis of the knee: an outcomes study.
abstract: BACKGROUND
  Ayurveda, the traditional system of healthcare in India, has many remedies for Osteoarthritis (OA). One of the ingredients most commonly found in Ayurvedic arthritis formulas is guggul, an oleoresin of the herb Commiphora mukul (CM). The authors have conducted both preclinical and clinical investigations of guggul for reduction of pain, stiffness, and improved function, and to determine tolerability in older patients with a diagnosis of OA of the knee.
  
  
  METHODS
  The study was conducted using an outcome, quasi-experimental, model. Thirty male and female participants meeting the inclusion/exclusion criteria, with a score of 2 or more on the Kellegran-Lawrence scale for at least 1 knee, were admitted in the study. CM was administered in capsule form (500 mg concentrated exact delivered TID) along with food. The WOMAC Total Score was used as a primary outcome measure. VAS scales, 6-minute walk-test, and WOMAC subscales were used as outcome measures.
  
  
  RESULTS
  At the end of treatment, there was a significant difference in the scores of the primary and secondary outcome measures. On the primary measure, WOMAC total score, participants were significantly improved (P < 0.0001) after taking the supplement for 1 month and continued to improve at the 2-month marker and follow-up. Secondary measures of pain in the VAS format demonstrated participant improvement; however, mood state, and current pain were not significantly different (P < 0.05) than baseline until the 2 month assessment (P < 0.001).
  
  
  CONCLUSIONS
  Overall data indicate significant improvement for participants during the trial in both scales and objective measures used for assessment purposes. There were no side effects reported during the trial. CM appears to be a relatively safe and effective supplement to reduce symptoms of OA.
authors.affiliation: Southern California University of Health Sciences, USA.
authors.forename: Betsy B
authors.initials: BB
authors.lastname: Singh
authors.forename: Lakshmi C
authors.initials: LC
authors.lastname: Mishra
authors.forename: Sivarama Prasad
authors.initials: SP
authors.lastname: Vinjamury
authors.forename: Nanette
authors.initials: N
authors.lastname: Aquilina
authors.forename: Vijay J
authors.initials: VJ
authors.lastname: Singh
authors.forename: Neil
authors.initials: N
authors.lastname: Shepard
mesh_terms: D000284:Administration, Oral; D000368:Aged; D029744:Commiphora; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008515:Medicine, Ayurvedic; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000188:drug therapy*; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010936:Plant Extracts