Efficacy and safety of bromelain: A systematic review and meta-analysis
Leelakanok N
Published in Nutrition and Health
Methodology
Systematic review and meta-analysis searching CINAHL Complete, MEDLINE, ScienceDirect, Scopus and Thai Journal Online from conception to August 2022; risk of bias assessed with RoB 2 or ROBINS-I; random-effects model with inverse variance weighting and DerSimonian-Laird estimation, heterogeneity by I-squared.
Key Findings
This review included 54 articles qualitatively and 39 in meta-analysis. Oral bromelain reduced pain slightly but significantly compared with controls (mean difference in pain score -0.27, 95% CI -0.45 to -0.08, 9 studies, I-squared 29%), and bromelain was detectable in serum with proteolytic activity retained after oral absorption. It appeared potentially effective for sinusitis but not for cardiovascular disease. Topical bromelain significantly shortened time to complete wound debridement (mean difference -6.89 days, 95% CI -7.94 to -5.83, 4 studies, I-squared 2%). Reported adverse events were flatulence, nausea and headache for oral use, with no major health risks identified.
Conclusions
Bromelain may be effective against sinusitis; major health risks were not reported.
Limitations
The pain benefit is very small (about a quarter of a point on a pain score) and of doubtful clinical importance, the included studies were of only moderate quality, and indications and doses varied widely across the 54 articles.
Supplements Studied
Bromelain may be effective against sinusitis but was not effective for cardiovascular diseases.
Related Health Concerns
Study Details
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