Until now glucosamine sulfate (GS) has been the most widely used supplement and 
has been shown to be efficacious in the treatment of osteoarthritis (OA). 
Methylsulfonylmethane (MSM) and boswellic acids (BA) are new effective 
supplements for the management of inflammation and joint degeneration, according 
to previous experimental studies. The aim of our study is to test the 
effectiveness of association of MSM and BA in comparison with GS in knee 
arthritis.In this prospective randomized clinical trial, MEBAGA 
(Methylsulfonylmethane and Boswellic Acids versus Glucosamine sulfate in the 
treatment of knee Arthritis), 120 participants affected by arthritis of the knee 
were randomly assigned to an experimental group (MB group) or a control group 
(GS group) treated for 60 days with 5 g of MSM and 7.2 mg of BA or with 1500 mg 
of GS daily, respectively. At the 2-month (T1) and 6-months (T2) follow-up , the 
efficacy of these two nutraceuticals was assessed using the visual analog pain 
scale (VAS) and the Lequesne Index (LI) for joint function, along with the use 
of anti-inflammatory drugs (non-steroidal anti-inflammatory drugs and 
anti-cyclooxygenase-2).The repeated measures ANOVA analysis shows that for VAS, 
LI, and the use of anti-inflammatory drugs scores there are improvements due to 
the time in the two groups (respectively, F=26.0; P<0.0001; F=4.15; P=0.02; 
F=3.38; P=0.04), with a tendency to better values for the MB group at T2.On the 
basis of these preliminary data, we could support the efficacy of the MSM in 
association with BA in the treatment of OA. These results are consistent with 
the anti-inflammatory and chondroprotective effects previously occurred in 
experimental studies. This new combination of integration (MSM and BS) has 
presented good results and satisfactory in comparison with GS, until now the 
cornerstone of the treatment of arthritis in according to guidelines.