Why was this study done?

We carried out this study to find out if a supplement combination (containing Boswellia serrata extract, pine bark extract, methylsulfonylmethane, curcumin, and piperine) is safe and helps treat knee osteoarthritis. This is an important question because many people with osteoarthritis use supplements, often several at once, but there is limited evidence on how well they work to reduce osteoarthritis pain.

Who took part in the study?

• 84 people took part in the study. Approximately half of our participants were men and half were women. Participants were, on average, 64 years old and had been living with knee osteoarthritis for about 5 years

• Because the study was conducted online and by post, we had participants from all over Australia

What happened during the study?

• The study ran for about a year, and the final participant finished their treatment in July 2025

• Participants were randomly assigned to two groups, and took either a supplement combination or placebo for 12 weeks

• Participants completed weekly surveys during the study

• We asked participants to rate their knee pain on a visual analogue scale (VAS) from 0 to 100, where 0 meant no pain and 100 meant the worst pain they could imagine

• We asked participants to report any health problems or side effects they experienced during the trial, even if they didn’t think it was caused by the study treatment

• The study was blinded, which meant participants didn’t know whether they were taking the supplement combination or the placebo until after they finished the treatment

What were the main results of the study?

• On average people in the supplement combination group and people in the placebo group reported that their knee pain decreased over the 12 weeks of the study

• On average, pain went down by about 20-21 points out of 100 from the start of the study to week 12. We usually consider a drop of 18 or more out of 100 to be a meaningful improvement in pain

• We did not find that the supplement combination worked better than the placebo at reducing knee pain. Both the treatment and placebo groups had similar improvements in knee pain

The graph below shows how pain changed over the 12–week period in the supplement combination (blue line) compared to the placebo (red line) group. As you can see from the graph, the change in pain over time was very similar between the groups.

Were there any side effects?

41% of people in the treatment group and 44% of people in the placebo group reported at least one health issue during the study – these were a mixture of issues related and unrelated to the study treatment. The most common issues were mild, including gastrointestinal symptoms and infections. The treatment and placebo groups had similar safety results. No serious side effects related to the study treatment were reported.

What do these results mean?

• Participants reported reduced pain after taking part in the 12-week trial, including those who received the placebo. Although the placebo treatment contained no active ingredients, it is quite common for participants in placebo groups to experience reduced pain. This has also been observed in many other studies of osteoarthritis

• The ATLAS study results are similar to findings from an earlier study our team ran in people with hand osteoarthritis using a supplement combination. That trial also found no difference in pain reduction between the treatment and placebo groups

• Supplements work better for some people than others. If you choose to try a supplement, it’s important to consider whether it's helping you and what it costs. You may want to try a new product for a short time (e.g. 4 weeks) and then decide whether to keep taking it based on any real improvement you notice

• You should always talk to your doctor before starting any new treatment. Even ‘natural’ products can have side effects or interact with other treatments you are taking

What happens next?

• Our team is currently working on several studies to find out whether other oral or topical supplements may help people with osteoarthritis

• Our team are also running a number of new trials looking at treatments and care for people with osteoarthritis. You can learn more about our work and new studies here.

Where can I find more information?

The full study results have been published in the Journal of Osteoarthritis and Cartilage and are freely available here.

Important notes

This summary does not replace advice from a healthcare professional. The results in this summary are based on the combined data from everyone who took part in the study. Your own experience during the study or with the study treatment may have been different from the overall results.

Thank you

We would like to express our thanks and appreciation to all ATLAS study participants. Although the trial didn’t find that the supplement combination was effective, this is still an important result and will guide treatment decisions for people with osteoarthritis and their healthcare providers. We couldn’t have successfully completed the ATLAS trial without our study participants.