Boswellic acids, the active components of Boswellia serrata (also known as Indian frankincense), have been traditionally used in Ayurvedic medicine for inflammatory conditions, including arthritis. In recent decades, several preclinical and clinical studies have investigated their potential role in supporting or treating rheumatoid arthritis (RA).

Scientific evidence suggests that boswellic acids have anti-inflammatory properties, primarily by inhibiting 5-lipoxygenase, an enzyme involved in the synthesis of leukotrienes, which are mediators in the inflammatory process. Some studies have also indicated a reduction in pro-inflammatory cytokines and a potential to prevent degradation of cartilage.

Small-scale clinical trials and pilot studies have reported improvements in joint pain, swelling, and physical function in RA patients treated with Boswellia extracts. However, these studies are often limited by small sample sizes, short durations, and variability in extract standardization. Systematic reviews and meta-analyses generally conclude that while preliminary data are promising, the evidence remains insufficient for strong recommendations due to methodological limitations and potential publication bias.

In summary, the use of boswellic acid for rheumatoid arthritis is supported by a modest level of scientific evidence, with some clinical support but a need for larger, high-quality trials to confirm efficacy and safety.