Rheumatoid Arthritis (RA) is an auto-immune, chronic inflammatory disease characterized by chronic inflammation and severe oxidative stress that causes progressive destruction of the joints thereby severely impacting Quality of Life (QoL) parameters [1,2]. Disability as a result of RA is one of the most important factors leading to loss of man-hours and drop in productivity.
Current treatment modalities are focused on providing symptomatic relief through the use of NSAIDs (Non-steroidal anti-inflammatory drugs) and DMARDs (Disease modifying anti-rheumatic drugs). However these drugs although effective are limited by their side effects which include gastrointestinal ulcerations, hemorrhagic events, nephrotoxicity induced by NSAIDs; infusion hypersensitivity reactions, and auto-immune responses triggered by TNFα inhibitors; and increased risk of severe infection, affecting mainly the respiratory tract, caused by biological drugs 
Therefore alternative therapy regimens involving botanicals, herbs, and phyto-remedies which have been proven to be effective since millennia and do not cause severe adverse events even on long-term use may offer key benefits in:
1. Providing symptomatic pain relief
2. Altering the course of the disease
Boswellia Serrata (Shallaki) a plant native to India often referred to as Indian Frankincense has been used for hundreds of years in ayurvedic medicine to treat arthritis. References to this guggulu (gum-resin) and its anti-arthritic/anti-rheumatic properties find mention in Charaka Samhita, Sushruta Samhita as well as in the Astanga Samgraha and Astanga Hridaya .
An extract of this herb has been shown to be effective and safe in providing relief in patients suffering from RA. This is due to its antioxidant and anti-arthritic properties. Several studies have shown that Boswellia Serrata is effective in reducing almost all inflammatory mediators (IL-1β, IL-6, TNF-α, IFN-γ and PGE). Boswellia Serrata was also effective in inducing significant and positive changes on articular elastase, MPO (myeloperoxidase), LPO (Lipid Peroxidation), GSH (Glutathione), catalase, SOD (Superoxide dismutase) and NO (Nitric Oxide). 
Studies further show that Boswellia Serrata is able to hinder cartilage breakdown by metalloproteinase-3 (MMP-3) and to block Intercellular Adhesion Molecule 1 (ICAM-1) and thereby the inflammatory reaction. These actions of Boswellia Serrata help prevent collagen and cartilage dissolution, thus preserving joint structure and health.
- Dragos D, et al. Nutrients. 2017; 9(1): 70
- Siddiqui MZ. Indian J Pharm Sci. 2011 May-Jun; 73(3): 255–261
- Umar S, et al. Phytomedicine. 2014; 21(6):847-856.