~ 248 ~ International Journal of Orthopaedics Sciences 2022; 8(2): 248-252 E-ISSN: 2395-1958 P-ISSN: 2706-6630 IJOS 2022; 8(2): 248-252 © 2022 IJOS www.orthopaper.com Received: 15-01-2022 Accepted: 22-02-2022 Dr. Anish Desai M.D., F.C.P., PGDHEP, Director, Strategic Medical Affairs, Intellimed Healthcare Solutions, Mumbai, Maharashtra, India Dr. Parshuram Shendge Ph.D., Manager, Intellimed Healthcare solutions, Mumbai, Maharashtra, India Dr. Sunaina Anand Pharm. D, Manager, Intellimed Healthcare solutions, Mumbai, Maharashtra, India Dr. Sreeni Nair Pharm D, Medical Affairs Executive, Intellimed Healthcare solutions, Mumbai, Maharashtra, India Corresponding Author: Dr. Anish Desai M.D., F.C.P., PGDHEP, Director, Strategic Medical Affairs, Intellimed Healthcare solutions, Mumbai, Maharashtra, India Clinical effectiveness and tolerability of Celery seed and Boswellia serrata extract in osteoarthritis Dr. Anish Desai, Dr. Parshuram Shendge, Dr. Sunaina Anand and Dr. Sreeni Nair DOI: https://doi.org/10.22271/ortho.2022.v8.i2d.3143 Abstract Background: Osteoarthritis (OA) is a common chronic articular degenerative disease marked by articular cartilage degradation, synovial inflammation/immunity, and subchondral bone lesion, among other symptoms. The disease affects 2–6% of the global population, and its prevalence increases with age, reaching 40% in people over the age of 70. Recently, there has been a surge of interest in using nutraceuticals to treat or prevent OA. Celery seed extract & Shallaki extracts (Boswellia serrata) effectively prevent cardiovascular disease, urinary tract infection, gout, and improve blood pressure. Experimental results indicate that both these extracts have anti-inflammatory properties. Aim: The current real-world evidence study was conducted to investigate the effectiveness of Celeract Advance Tablet in OA patients. Methods: A total of 1236 patients were enrolled in the study. All patients received Celeract Advance Tablet for 90 days. Clinical assessment of symptoms included palpation tiredness, mobility limitation, joint crepitus, swelling and redness. Osteoarthritis symptoms were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Total European Quality of Life–5 Dimensions and visual analogue scale (VAS). Results: After 90 days treatment with Celeract Advance Tablet, WOMAC score reduced significantly from 62.64 + 20.47 to 17.22 + 17.59 (p< 0.05). For Total European Quality of Life–5 Dimensions (EQ- 5D) score significantly improved from 38.76 + 8.10 to 69.13 + 8.60 ( p< 0.05). From the baseline, 78.35% improvement in EQ-5D was observed in patients treated for three months. After 90 days, VAS score for pain significantly reduced from 8.07 + 5.38 to 1.78 + 4.46 (P< 0.05) after 90 days in OA patients. No major adverse reactions were reported. Conclusion: The current study revealed that the Celeract Advance tablet effectively improves joint pain, stiffness, physical function and quality of life in OA patients. Keywords: Osteoarthritis, Celery seed extract, Shallaki extracts, anti-inflammatory, NSAIDs, Apiaceae Introduction Osteoarthritis (OA) is a chronic pain condition affecting an individual's quality of life. OA is the most frequent cause of musculoskeletal pain [1] . In geriatric patients above 60 years of age, the prevalence of OA is more in men (10%) than women (13%). About 10-15% of geriatric patients show signs and symptoms of OA, with a higher prevalence in women compared to men. In India, the prevalence of OA is higher in the rural population (56.6%) than urban (32.6%). Due to lifestyle changes, the Asian population is highly exposed to the risk of knee osteoarthritis compared to Europeans and Americans [2, 3, 4] . The pain in osteoarthritis is caused by multiple factors driven by nociceptive and neuropathic mechanisms, along with abnormal pain pathways of the peripheral and central nervous system (CNS). Inflammation in the joint initiates a cascade of events which leads to increased sensitivity of nociceptive primary afferent neurons, peripheral sensitization, and hyper-excitability of the nociceptive neurons in the CNS [5] . Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in the management of arthritic stiffness and other rheumatic diseases [6] . Although NSAIDs are recommended by clinical guidelines for managing pain and inflammation in OA (first-line treatment), NSAIDs show various adverse effects, including cardiovascular, renal, hepatic and gastrointestinal [1, 6] . A celery seed extract has anti-inflammatory, analgesic, and gastro-protective properties.