Research

Bromelain

65 peer-reviewed studies curated from PubMed and Semantic Scholar.

7
Meta-analyses
13
Systematic reviews
41
RCTs
4
Other studies
Meta-analyses (11%)
Systematic reviews (20%)
RCTs (63%)
Observational (2%)

Studies

Sorted by quality and recency

2026·Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society·Ulgar Boran Günay, Muhammet Kadir Tanin, Anıl Demiröz

Efficacy and Safety of Bromelain-Based Enzymatic Debridement for Chronic Wounds: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

Meta-analysisn = 314

Systematic review and meta-analysis of RCTs evaluating bromelain-based enzymatic debridement (BBD) for chronic wounds. BBD increased complete debridement compared to control without increasing adverse events, suggesting its potential as a non-surgical adjunct in wound care.

PubMedRead on PubMed
2026·Medical sciences (Basel, Switzerland)·Stefana Avadanei-Luca, Dan-Cristian Moraru, Andra-Irina Bulgaru-Iliescu, et al

Histopathological Changes Following Bromelain-Based Enzymatic Debridement (NexoBrid): A Comprehensive Systematic Review of Preclinical and Clinical Evidence.

Systematic review

This systematic review evaluates preclinical and clinical studies on bromelain-based enzymatic debridement for thermal burns. Preclinical studies showed selective eschar removal with dermal preservation and accelerated re-epithelialization. Clinical data are limited, highlighting a need for more prospective studies.

PubMedRead on PubMed
2025·Journal of burn care & research : official publication of the American Burn Association·Lucas R De Freitas, Ofonime Chantal Udoma-Udofa, Pedro Henrique Reginato, et al

Bromelain-Based Enzymatic Debridement Versus Standard of Care in Deep Burn Injuries: A Systematic Review and Meta-Analysis.

Meta-analysisn = 484Skin Hair Health

This systematic review and meta-analysis compared bromelain-based enzymatic debridement to standard care in managing partial and full thickness burns. Bromelain significantly reduced time to eschar removal and the risk of surgical excision and need for autografts, without affecting wound closure time or long-term scar quality.

PubMedRead on PubMed
2025·BMC pulmonary medicine·Diana Petkova, Rosen Petkov, Vladimir Hodzhev, et al

Efficacy and safety of AtusinCAP in the treatment of acute uncomplicated bronchitis in the primary care setting: a multi-center, randomized, double-blind, placebo-controlled study (AABA).

RCTn = 310

A multi-center, randomized, double-blind, placebo-controlled study evaluated the efficacy and safety of AtusinCAP, a supplement combining essential oils, bromelain, and green Brazilian propolis, in treating acute uncomplicated bronchitis. The study found a statistically significant higher number of clinically cured participants in the AtusinCAP group compared to placebo, with no differences in adverse events.

PubMedRead on PubMed
2025·VASA. Zeitschrift fur Gefasskrankheiten·Giacomo Buso, Paolo Santini, Francesca Ghirardini, et al

The role of Bromelain and Liposomal Vitamin C in the treatment of chronic venous disease.

Systematic review

Systematic review evaluating the efficacy and safety of bromelain and vitamin C in the treatment of chronic venous disease (CVD). The review found that CVD-related symptoms and edema seem to improve with dietary supplements containing these compounds, with no major safety issues reported. However, no studies evaluated the effects of bromelain and vitamin C alone or in combination.

PubMedRead on PubMed
2025·Journal of medicinal food·Irislene Costa Pereira, Raquel Barros Passos, Camila de Meneses Caetano Viana, et al

Supplementation Containing Bromelain on the Side Effects of Oncological Treatment: Systematic Review.

Systematic reviewInflammation

Systematic review evaluating bromelain-containing supplements to improve side effects of cancer treatment. Bromelain supplementation was observed to reduce side effects such as mucosal dryness, arthralgia, and peripheral neuropathy induced by chemotherapy.

PubMedRead on PubMed
2025·The Journal of pharmacy and pharmacology·Jaafaru Sani Mohammed, Abdulrahman T Ahmed, Mandeep Singh, et al

Evaluating the role of bromelain in diabetes management: a systematic review of research evidence and mechanisms of action.

Systematic reviewNutrition

Systematic review evaluating the role of bromelain in diabetes management. Bromelain supplementation showed positive effects on metabolic markers, potentially enhancing glucose uptake and utilization, and improving glycemic and lipid indices in diabetes. Further research is needed to clarify mechanisms, including interactions with the incretin system.

PubMedRead on PubMed
2025·Clinical nutrition ESPEN·Irislene Costa Pereira, Álina Mara Carvalho Pedrosa-Santos, Jorddam Almondes Martins, et al

Bromelain and liver health: A comprehensive systematic review of preclinical studies.

Systematic review

Systematic review of preclinical studies evaluating bromelain's effects on liver injuries. Bromelain shows potential prophylactic and curative effects, decreasing enzyme levels, enhancing liver structure, reducing oxidative stress markers, and regulating lipid metabolism.

PubMedRead on PubMed
2024·Natural product research·Taline Alves Nobre, Athanara Alves de Sousa, Irislene Costa Pereira, et al

Bromelain as a natural anti-inflammatory drug: a systematic review.

Systematic reviewInflammation

Systematic review evaluating the anti-inflammatory activity of bromelain on different cell lines. Bromelain reduced IL-1β, IL-6, and TNF-α secretion, modulating the inflammatory response and accelerating the healing process.

PubMedRead on PubMed
2024·Nutrients·Urna Kansakar, Valentina Trimarco, Maria V Manzi, et al

Exploring the Therapeutic Potential of Bromelain: Applications, Benefits, and Mechanisms.

Systematic review

This systematic review explores the therapeutic potential of bromelain, a mixture of proteolytic enzymes from pineapple. It covers the history, structure, chemical properties, and medical indications of bromelain, highlighting its recognition in traditional and modern medicine.

PubMedRead on PubMed
2024·Journal of burn care & research : official publication of the American Burn Association·Bishara Atiyeh, Kareem Makkawi, Paul Beaineh

Burn Wounds and Enzymatic Debridement (ED)-Past, Present, and Future.

Systematic review

Systematic review of enzymatic debridement (ED) for burn wounds, focusing on pineapple bromelain-based debridement (BBD). The review includes 46 studies, with 23 clinical studies showing promising results for BBD in the last 3 years. While BBD is not yet a replacement for surgical standard of care, it is a promising alternative.

PubMedRead on PubMed
2023·Clinical nutrition ESPEN·Irislene Costa Pereira, Eduardo Emanuel Sátiro Vieira, Lucillia Rabelo de Oliveira Torres, et al

Bromelain supplementation and inflammatory markers: A systematic review of clinical trials.

Systematic reviewInflammation

Systematic review of randomized controlled trials assessing bromelain supplementation's anti-inflammatory effects in adults. Most studies showed a reduction in inflammatory parameters with bromelain, either alone or in combination, but results were inconsistent due to population heterogeneity, doses, and treatment duration.

PubMedRead on PubMed
2023·Nutrition and health·Nattawut Leelakanok, Arpa Petchsomrit, Thitapa Janurai, et al

Efficacy and safety of bromelain: A systematic review and meta-analysis.

Meta-analysisInflammation Joint Bone Health

This systematic review and meta-analysis assessed the efficacy and safety of bromelain. Bromelain showed potential in pain control and wound care, with moderate-quality studies supporting its use. It was effective against sinusitis but not cardiovascular diseases. Adverse events included flatulence, nausea, and headache.

PubMedRead on PubMed
2023·International wound journal·Yaron Shoham, Konstantinos Gasteratos, Adam J Singer, et al

Bromelain-based enzymatic burn debridement: A systematic review of clinical studies on patient safety, efficacy and long-term outcomes.

Systematic review

Systematic review of clinical studies on Bromelain-based enzymatic burn debridement (NexoBrid®) for adult deep burns. The review reports positive effects on burn debridement, functional and cosmetic outcomes, scarring, and quality of life, with no strong evidence of adverse events like coagulopathy or burn wound infection. Benefits include faster debridement and healing times, reduced operations, and prevention of compartment syndrome.

PubMedRead on PubMed
2020·Journal of burn care & research : official publication of the American Burn Association·Seyed Hamid Salehi, Mahnoush Momeni, Masoud Vahdani, et al

Clinical Value of Debriding Enzymes as an Adjunct to Standard Early Surgical Excision in Human Burns: A Systematic Review.

Systematic review

Systematic review of clinical trials investigating enzymatic debridement agents for burn wounds in humans. Bromelain and collagenase were highlighted, with bromelain potentially reducing surgical debridement sessions. Nexobrid was effective in deep burns. More studies are needed to clarify the role of these enzymes.

PubMedRead on PubMed
2018·International journal of oral and maxillofacial surgery·R de A C Almeida, F C M de Sousa Lima, B C do E Vasconcelos

Is bromelain an effective drug for the control of pain and inflammation associated with impacted third molar surgery? Systematic review and meta-analysis.

Meta-analysisn = 252Inflammation

Systematic review and meta-analysis of randomized controlled trials assessing bromelain for pain and inflammation control after third molar surgery. Bromelain was effective at controlling postoperative pain at 48-72 hours after surgery but did not significantly affect oedema or trismus compared to control.

PubMedRead on PubMed
2007·The Cochrane database of systematic reviews·H M Snowden, M J Renfrew, M W Woolridge

WITHDRAWN: Treatments for breast engorgement during lactation.

Systematic reviewn = 424

Systematic review of treatments for breast engorgement in breastfeeding women, including cabbage leaves, ultrasound, Danzen, and bromelain/trypsin complex. Bromelain/trypsin complex significantly improved symptoms compared to placebo, while cabbage leaves and gel packs were equally effective.

PubMedRead on PubMed
2001·The Cochrane database of systematic reviews·H M Snowden, M J Renfrew, M W Woolridge

Treatments for breast engorgement during lactation.

Systematic reviewn = 424

Systematic review of treatments for breast engorgement in breastfeeding women, including 8 trials with 424 women. Cabbage leaves, ultrasound, and placebo were equally effective. Danzen and bromelain/trypsin complex significantly improved engorgement symptoms compared to placebo.

PubMedRead on PubMed
2025·Clinical and experimental dental research·Shabnam Ajami, Seyyed Hadi Hosseini, Neda Babanouri, et al

Analgesic Efficacy of Bromelain and Bromelain Plus Turmeric for Pain Control After Orthodontic Separator Placement: A Triple-Blind Randomized Clinical Trial.

RCTn = 135

Triple-blind RCT comparing analgesic efficacy of Bromelain, Ibuprofen, and Bromelain plus turmeric in 135 patients after orthodontic separator placement. Bromelain and Bromelain plus turmeric groups experienced lower pain scores at 2h and 6h post-treatment compared to Ibuprofen. At 48h, Bromelain group reported higher pain scores in chewing function than Ibuprofen.

PubMedRead on PubMed
2025·Retina (Philadelphia, Pa.)·Paola Marolo, Giovanni Li Volti, Anna Nicolosi, et al

COMBINED INTRAVITREAL AFLIBERCEPT AND ANTI-INFLAMMATORY ORAL SUPPLEMENTATION IN THE TREATMENT OF DIABETIC MACULAR EDEMA: Two-Year Randomized Controlled Trial Results.

RCTn = 134

RCT comparing intravitreal aflibercept alone versus aflibercept combined with oral Lenidase supplementation (containing baicalin, bromelain, and escin) in 134 eyes with diabetic macular edema. Group B required fewer injections over 24 months, with similar efficacy in visual acuity and macular thickness improvement compared to Group A.

PubMedRead on PubMed
2025·Advances in wound care·Marissa J Carter, Robert J Snyder, Keren David Zarbiv, et al

The Correlation Between Wound Bed Preparation and Wound Closure in Venous Leg Ulcers: AAnalysis of the ChronEx Multicenter Randomized Controlled Trial.

RCTn = 119

This study analyzed the correlation between wound bed preparation and wound closure in venous leg ulcers using data from a randomized controlled trial. Patients were treated with bromelain-based enzymatic debridement, placebo gel vehicle, or nonsurgical standard of care. Wound closure incidence was higher in wounds that achieved wound bed preparation.

PubMedRead on PubMed
2025·Scientific reports·L I Sgaramella, A Pasculli, M Moschetta, et al

Randomized controlled trial of bromelain and alpha-lipoic acid in breast conservative surgery.

RCTn = 114Inflammation

Double-blind randomized placebo-controlled trial on 114 candidates for breast conservative surgery (BCS) to analyze the effects of bromelain and alpha-lipoic acid on early complications like oedema and seroma. Group A received a combination of supplements including bromelain and alpha-lipoic acid, showing statistically fewer oedema and seroma compared to placebo.

PubMedRead on PubMed
2025·Scientific reports·Pedram Delgarm, Marjan Mokhtare, Nasser Ebrahimi Daryani, et al

Effects of bromelain supplementation on disease activity and quality of life in patients with ulcerative colitis: a randomized, triple-blind, placebo-controlled study.

RCTn = 70Gut Health

This randomized, triple-blind, placebo-controlled study evaluated the effects of bromelain supplementation on disease activity and quality of life in 70 patients with mild-to-moderate ulcerative colitis. Bromelain supplementation significantly improved the Simple Clinical Colitis Activity Index (SCCAI) scores compared to placebo, indicating reduced disease severity, but did not significantly affect quality of life scores.

PubMedRead on PubMed
2025·Molecular nutrition & food research·Alessandro Colletti, Luciano Sangiorgio, Alma Martelli, et al

Bromelain-Rich Pineapple Extract for the Treatment of Pediatric Patients With Orchiepididymitis: A Randomized Clinical Pilot Study.

RCTn = 60Inflammation

A randomized clinical pilot study involving 60 pediatric patients with orchiepididymitis compared the effects of a bromelain-rich pineapple extract (Brome-Inf) to a placebo over 15 days. The Brome-Inf group showed significant reductions in pain and edema, suggesting it as a promising co-management option for this condition.

PubMedRead on PubMed
2025·Wounds : a compendium of clinical research and practice·Cyaandi R Dove, Robert J Snyder, Keren David Zarbiv, et al

Bromelain-based debridement versus collagenase ointment debridement of venous leg ulcers: post hoc analysis of the ChronEx trial.

RCTn = 54

Post hoc analysis of the ChronEx trial comparing bromelain-based enzymatic debridement (BBD) to collagenase ointment (CO) for venous leg ulcers. BBD was more effective, with 63% of wounds completely debrided and 50% achieving complete granulation within 2 weeks, compared to none with CO. BBD also had faster median times to complete debridement and granulation.

PubMedRead on PubMed
2024·Annali italiani di chirurgia·Giuseppe Massimiliano De Luca, Alessandro De Luca, Lucia Franzoso, et al

A Nutraceutical Combination of Bromelain and Boswellia Serrata Casperome® in Siben®: Effects on the Postoperative Course of Inguinal Hernioplasty with Mesh at One Year Follow up. A Randomized Multicentric Study.

RCTn = 180Inflammation Recovery

RCT of 180 patients undergoing open tension-free hernioplasty with mesh, comparing a nutraceutical combination of Bromelain and Boswellia serrata to placebo. The study group showed significant improvements in postoperative pain, earlier resumption of daily activities, and better Quality of Life scores at one-year follow-up.

PubMedRead on PubMed
2021·Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society·Yaron Shoham, Eyal Shapira, Josef Haik, et al

Bromelain-based enzymatic debridement of chronic wounds: Results of a multicentre randomized controlled trial.

RCTn = 73

Multicentre RCT assessing the safety and efficacy of bromelain-based enzymatic debridement agent EscharEx in chronic wounds. The EscharEx arm achieved a significantly higher incidence of complete debridement compared to the gel vehicle arm, meeting the primary endpoint. No significant differences were found in complete wound closure or time to closure between the arms.

PubMedRead on PubMed
2019·Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons·Shaopeng Liu, Haoming Zhao, Ye Wang, et al

Oral Bromelain for the Control of Facial Swelling, Trismus, and Pain After Mandibular Third Molar Surgery: A Systematic Review and Meta-Analysis.

Meta-analysisInflammation

Systematic review and meta-analysis of six RCTs evaluating bromelain's effect on facial swelling, pain, and trismus after mandibular third molar surgery. Bromelain was effective in reducing facial swelling and alleviating pain 7 days post-surgery, but had no significant effect on trismus.

PubMedRead on PubMed
2019·Medicina oral, patologia oral y cirugia bucal·M-L-T Mendes, E-M do Nascimento-Júnior, D-M Reinheimer, et al

Efficacy of proteolytic enzyme bromelain on health outcomes after third molar surgery. Systematic review and meta-analysis of randomized clinical trials.

Meta-analysisSleep

Systematic review and meta-analysis of six RCTs evaluating bromelain's effects on health outcomes after third molar surgery. Bromelain showed a large effect size in improving physical appearance, social isolation, and sleep quality during the first postoperative week, and reduced pain intensity during the first 24 hours and 7 days after surgery. No evidence was found for reducing trismus and facial swelling.

PubMedRead on PubMed
2018·Phytotherapy research : PTR·Glaciele Maria de Souza, Ighor Andrade Fernandes, Cássio Roberto Rocha Dos Santos, et al

Is bromelain effective in controlling the inflammatory parameters of pain, edema, and trismus after lower third molar surgery? A systematic review and meta-analysis.

Meta-analysisInflammation

Systematic review and meta-analysis evaluating bromelain's effectiveness in reducing pain, edema, and trismus after lower third molar surgeries. The analysis included seven studies in the systematic review and four in the meta-analysis, showing bromelain significantly reduced these inflammatory parameters.

PubMedRead on PubMed
2005·Multiple sclerosis (Houndmills, Basingstoke, England)·U Baumhackl, L Kappos, E W Radue, et al

A randomized, double-blind, placebo-controlled study of oral hydrolytic enzymes in relapsing multiple sclerosis.

RCTn = 301Brain Health -

A randomized, double-blind, placebo-controlled trial of oral hydrolytic enzymes, including bromelain, trypsin, and rutosid, in 301 patients with relapsing multiple sclerosis. No treatment effect was found between the placebo and the enzyme groups for clinical or MRI parameters.

PubMedRead on PubMed
2025·Aesthetic plastic surgery·Benyamin Rahmaty, Mohsen Naraghi, Alireza Mesbahi, et al

The Effectiveness of Bromelain on Oedema, Subconjunctival Haemorrhage, and Ecchymosis After Rhinoplasty: A Randomised, Double-Blind, Placebo-Controlled Trial.

RCTn = 46

Randomised, double-blind, placebo-controlled trial evaluating the effectiveness of bromelain on periorbital oedema, subconjunctival haemorrhage, and ecchymosis after rhinoplasty. Bromelain was significantly effective in reducing subconjunctival haemorrhage and ecchymosis on the seventh day post-operatively, but not on oedema.

PubMedRead on PubMed
2025·RMD open·Yves Henrotin, Thomas Pap, Siddhartha Lieten, et al

Oral enzyme combination therapy reduces systemic inflammation, urinary CTXII and pain in knee osteoarthritis: a proof-of-mechanism, randomised, crossover, double-blind, placebo-controlled trial.

RCTn = 45Inflammation Joint Bone Health

RCT of oral enzyme combination therapy with bromelain, trypsin, and rutoside in 45 patients with knee osteoarthritis. The therapy reduced systemic inflammation, urinary CTXII, and pain, with significant improvements in KOOS Pain and Symptoms subdomains.

PubMedRead on PubMed
2025·Journal of cosmetic dermatology·Ali Asilian, Parisa Mohammadian, Hadiseh Mahram, et al

Investigating the Efficacy and Safety of Oral Cicaglocal on Wound Healing After Mohs Surgery in Patients With Skin Cancer: A Randomized, Double-Blinded, Placebo-Controlled Clinical Trial.

RCTn = 24Skin Hair Health

This randomized, double-blinded, placebo-controlled clinical trial evaluated the efficacy and safety of Cicaglocal, a supplement containing bromelain, Centella asiatica, hyaluronan, vitamins, and minerals, on wound healing after Mohs surgery in 24 patients with skin cancer. Cicaglocal significantly improved outcomes in terms of erythema score, early healing score, full recovery score, and patient and physician satisfaction levels compared to placebo.

PubMedRead on PubMed
2024·Nutrients·Alessandro Colletti, Chiara Procchio, Mariaelena Pisano, et al

An Evaluation of the Effects of Pineapple-Extract and Bromelain-Based Treatment after Mandibular Third Molar Surgery: A Randomized Three-Arm Clinical Study.

RCTn = 42Inflammation

A three-arm, randomized, placebo-controlled clinical study evaluated the effects of lyophilized pineapple extract with bromelain and purified bromelain on pain, swelling, trismus, and quality of life after mandibular third molar surgery. The study found significant reductions in pain and swelling and improved quality of life in the bromelain and pineapple groups compared to placebo. Both active treatments reduced the need for NSAIDs, suggesting they are effective alternatives for postoperative care.

PubMedRead on PubMed
2024·The British journal of surgery·Lidia Rodríguez-Ortiz, Mari C Vázquez-Borrego, Florina I Bura, et al

Intra-tumoural bromelain and N-acetylcysteine for recurrent and unresectable pseudomyxoma peritonei: phase I/II trial.

RCT

Phase I/II trial investigating the use of intra-tumoural bromelain and N-acetylcysteine for treating recurrent and unresectable pseudomyxoma peritonei.

PubMedRead on PubMed
2023·Annali italiani di chirurgia·Stefano Parrini, Camilla De Ambrosi, Glauco Chisci

The role of oral bromelain on "bad outcome" in mandibular third molar surgery. A split-mouth comparative study.

RCTn = 49Inflammation

Prospective split-mouth clinical study of 49 patients evaluating the efficacy of 9.6 g bromelain after mandibular third molar surgery. Bromelain administration resulted in a statistically significant reduction in postoperative facial swelling compared to no bromelain use.

PubMedRead on PubMed
2023·BMC oral health·Hossein Babazade, Arad Mirzaagha, Shokoofeh Konarizadeh

The effect of bromelain in periodontal surgery: a double-blind randomized placebo-controlled trial.

RCTn = 28Inflammation

This double-blind randomized placebo-controlled trial evaluated the effect of bromelain on periodontal indices after pocket elimination surgery in 28 patients. Bromelain significantly reduced bleeding on probing compared to placebo, but there were no significant differences in gingival index, plaque index, or pocket probing depth.

PubMedRead on PubMed
2020·The Angle orthodontist·Jennifer Rose, Ahmed Ghoneima, Frank Lippert, et al

A visual evaluation of oral plaque removal utilizing an adjunct enzyme pre-rinse in orthodontic subjects.

RCTn = 43

This double-blind, crossover clinical trial evaluated the effect of a bromelain enzyme pre-rinse on plaque removal in 43 orthodontic subjects. No significant differences in plaque scores were observed between the enzyme and placebo groups. Significant plaque reduction was noted after brushing and Waterpik use in both groups.

PubMedRead on PubMed
2020·Pakistan journal of pharmaceutical sciences·Hira Naeem, Syed Naim-Ul-Hassan Naqvi, Rehana Perveen, et al

Efficiency of proteolytic enzymes in treating lumbar spine osteoarthritis (low back pain) patients and its effects on liver and kidney enzymes.

RCTn = 40Joint Bone Health Inflammation

RCT comparing bromelain and papain enzyme supplements with aceclofenac in 40 patients with lumbar spine osteoarthritis. The enzyme group showed significantly reduced pain scores and improved quality of life without affecting BMI or vital signs.

PubMedRead on PubMed
2018·Clinical oral investigations·Gaetano Isola, Marco Matarese, Luca Ramaglia, et al

Efficacy of a drug composed of herbal extracts on postoperative discomfort after surgical removal of impacted mandibular third molar: a randomized, triple-blind, controlled clinical trial.

RCTn = 82

RCT of 82 patients comparing a phytotherapeutic drug composed of baicalin, bromelain, and escin to placebo and ibuprofen for postoperative pain management after mandibular third molar surgery. The phytotherapeutic drug significantly reduced postoperative pain scores at 12, 24, and 48 hours compared to placebo and ibuprofen.

PubMedRead on PubMed
2017·The Journal of craniofacial surgery·Paolo Ghensi, Alessandro Cucchi, Luca Creminelli, et al

Effect of Oral Administration of Bromelain on Postoperative Discomfort After Third Molar Surgery.

RCTn = 84Inflammation

This RCT evaluated the effect of oral bromelain on postoperative discomfort after mandibular third molar surgery in 84 patients. Bromelain alone showed moderate anti-inflammatory efficacy, reducing postoperative swelling, but not significantly compared to no drug. The combination of bromelain and dexamethasone significantly reduced postoperative swelling and analgesic use.

PubMedRead on PubMed
2016·Chinese journal of integrative medicine·Chit Moy Ley, Qing Ni, Xing Liao, et al

Bromelain and cardiovascular risk factors in diabetes: An exploratory randomized, placebo controlled, double blind clinical trial.

RCTn = 68

This RCT investigated the effect of 12 weeks of bromelain supplementation on plasma fibrinogen and other cardiovascular disease risk factors in 68 Chinese diabetic patients. The study found no significant difference in fibrinogen levels or other CVD risk factors between the bromelain and placebo groups.

PubMedRead on PubMed
2016·Phytotherapy research : PTR·Kai-Hendrik Bormann, Kristina Weber, Heike Kloppenburg, et al

Perioperative Bromelain Therapy after Wisdom Teeth Extraction - A Randomized, Placebo-Controlled, Double-Blinded, Three-Armed, Cross-Over Dose-Finding Study.

RCTn = 68Inflammation

This randomized, placebo-controlled, double-blinded, three-armed, cross-over dose-finding study investigated the efficacy of bromelain in reducing postoperative edema and inflammatory reactions after wisdom teeth extraction. The study compared dosages of 1000 FIP, 3000 FIP, and 4500 FIP in 75 patients, with 68 analyzed. While higher dosages did not show superiority over 1000 FIP, pooled bromelain treatments showed a trend favoring bromelain over placebo for reducing swelling, pain, and difficulty in swallowing.

PubMedRead on PubMed
2014·Quintessence international (Berlin, Germany : 1985)·Paolo Ordesi, Luca Pisoni, Pierluigi Nannei, et al

Therapeutic efficacy of bromelain in impacted third molar surgery: a randomized controlled clinical study.

RCTn = 80Inflammation

RCT evaluating the efficacy of bromelain in reducing postoperative pain and swelling in 80 patients undergoing impacted third molar surgery. Bromelain significantly reduced postoperative pain, edema, and erythema compared to the control group.

PubMedRead on PubMed
2012·Phytotherapy research : PTR·Silke Müller, Reinhard März, Manfred Schmolz, et al

Placebo-controlled randomized clinical trial on the immunomodulating activities of low- and high-dose bromelain after oral administration - new evidence on the antiinflammatory mode of action of bromelain.

RCTImmunity Inflammation

Placebo-controlled randomized clinical trial investigating the immunomodulating activities of low- and high-dose bromelain on inflammation-related cytokines. Bromelain significantly shifted the circadian profiles of cytokines, suggesting an effect on the antigen-specific T cell compartment of the human immune system.

PubMedRead on PubMed
2004·Clinical rheumatology·Naseer M Akhtar, Rizwan Naseer, Abid Z Farooqi, et al

Oral enzyme combination versus diclofenac in the treatment of osteoarthritis of the knee--a double-blind prospective randomized study.

RCTn = 103Joint Bone Health

This double-blind, randomized study compared the efficacy and safety of an oral enzyme-rutosid combination (ERC) containing bromelain, trypsin, and rutosid with diclofenac in 103 patients with osteoarthritis of the knee. Both treatments resulted in significant improvements in the Lequesne's Algofunctional Index and complaint index, with ERC showing non-inferiority to diclofenac. ERC was considered an effective and safe alternative to NSAIDs for treating painful episodes of knee osteoarthritis.

PubMedRead on PubMed
2002·The Journal of the Association of Physicians of India·S K Shahid, N H Turakhia, M Kundra, et al

Efficacy and safety of phlogenzym--a protease formulation, in sepsis in children.

RCTn = 60Immunity

Double-blind, randomized controlled trial of 60 children with sepsis testing the efficacy and safety of Phlogenzym, an oral enzyme formulation containing bromelain, trypsin, and rutin, as adjuvant therapy. The Phlogenzym group showed faster recovery in terms of fever subsidence and reduced need for haemodynamic support compared to placebo.

PubMedRead on PubMed
2019·European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·S J Valle, J Akhter, A H Mekkawy, et al

A novel treatment of bromelain and acetylcysteine (BromAc) in patients with peritoneal mucinous tumours: A phase I first in man study.

RCTn = 20

Phase I study of Bromelain and Acetylcysteine (BromAc) in 20 patients with mucinous peritoneal tumours. The study assessed safety and preliminary efficacy, finding a manageable safety profile and considerable mucolytic activity, with an objective response in 73.2% of treated sites.

PubMedRead on PubMed
2017·Journal of burn care & research : official publication of the American Burn Association·Alexandra Schulz, Yaron Shoham, Lior Rosenberg, et al

Enzymatic Versus Traditional Surgical Debridement of Severely Burned Hands: A Comparison of Selectivity, Efficacy, Healing Time, and Three-Month Scar Quality.

RCTn = 40

This single-center, controlled clinical trial compared enzymatic debridement with bromelain (NexoBrid, EDNX) to traditional surgical debridement (TSD) in 40 patients with deep dermal hand burns. EDNX significantly reduced time to complete debridement and healing, improved burn depth evaluation, and reduced the need for autografting compared to TSD. Scar quality after 3 months was nearly equivalent between the groups.

PubMedRead on PubMed
2017·Burns : journal of the International Society for Burn Injuries·Alexandra Schulz, Paul Christian Fuchs, Irene Rothermundt, et al

Enzymatic debridement of deeply burned faces: Healing and early scarring based on tissue preservation compared to traditional surgical debridement.

RCTn = 26

A single-center clinical trial comparing enzymatic debridement using bromelain to traditional surgical debridement in 26 subjects with deep dermal facial burns. Enzymatic debridement significantly reduced time to wound closure and improved scar quality after 12 months compared to surgical debridement.

PubMedRead on PubMed
2016·Clinical rheumatology·Thitima Kasemsuk, Nadhaporn Saengpetch, Nathawut Sibmooh, et al

Improved WOMAC score following 16-week treatment with bromelain for knee osteoarthritis.

RCTn = 40Joint Bone Health

Randomized, single-blind, active-controlled pilot study of 40 knee osteoarthritis patients comparing 16-week treatment with bromelain (500 mg/day) to diclofenac (100 mg/day). Bromelain improved total WOMAC scores, pain, stiffness, and function subscales, and physical component of SF-36 at week 16 compared to baseline. No significant difference between bromelain and diclofenac after 4 weeks.

PubMedRead on PubMed
2015·European journal of sport science·Cecilia M Shing, Suzzen Chong, Matthew W Driller, et al

Acute protease supplementation effects on muscle damage and recovery across consecutive days of cycle racing.

RCTn = 15Recovery Physical Performance

RCT of 15 highly trained cyclists examining the effects of bromelain supplementation (1000 mg/day) versus placebo over six days of competitive racing. Bromelain reduced subjective feelings of fatigue and showed a trend to maintain testosterone concentration, despite increased markers of muscle damage in both groups.

PubMedRead on PubMed
2014·Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons·Omer Waleed Majid, Bashar Adil Al-Mashhadani

Perioperative bromelain reduces pain and swelling and improves quality of life measures after mandibular third molar surgery: a randomized, double-blind, placebo-controlled clinical trial.

RCTn = 45Inflammation

RCT comparing oral bromelain (4 × 250 mg) to diclofenac sodium (4 × 25 mg) and placebo on pain, swelling, trismus, and quality of life after mandibular third molar surgery. Bromelain significantly reduced pain and improved quality of life compared to placebo, with effects comparable to diclofenac.

PubMedRead on PubMed
2014·Medicina oral, patologia oral y cirugia bucal·M-C de la Barrera-Núñez, R-M Yáñez-Vico, A Batista-Cruzado, et al

Prospective double-blind clinical trial evaluating the effectiveness of Bromelain in the third molar extraction postoperative period.

RCTn = 34Inflammation -

Prospective double-blind clinical trial evaluating the anti-inflammatory and analgesic effects of Bromelain in the postoperative period after third molar extraction. Although no statistically significant differences were found, a trend towards less inflammation and improved oral aperture was observed in the Bromelain group.

PubMedRead on PubMed
2009·Medicine and science in sports and exercise·Thomas W Buford, Matthew B Cooke, Liz L Redd, et al

Protease supplementation improves muscle function after eccentric exercise.

RCTn = 29Physical Performance Inflammation Recovery

RCT investigating the effects of protease supplementation on muscle function after eccentric exercise. The protease group showed higher force production and reduced inflammation markers compared to placebo, suggesting improved recovery and muscle function.

PubMedRead on PubMed
2007·The Journal of dermatological treatment·Risulo Massimiliano, Rubegni Pietro, Sbano Paolo, et al

Role of bromelain in the treatment of patients with pityriasis lichenoides chronica.

RCTn = 8Skin Hair Health

Study evaluated the efficacy of bromelain in treating pityriasis lichenoides chronica (PLC) in 8 patients. All patients showed complete clinical recovery after treatment, with two experiencing relapse but responding to another brief cycle of therapy. No side effects were reported.

PubMedRead on PubMed
2006·QJM : monthly journal of the Association of Physicians·S Brien, G Lewith, A F Walker, et al

Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study.

RCTn = 47Joint Bone Health -

Randomized, double-blind placebo-controlled trial assessing the efficacy of bromelain 800 mg/day for 12 weeks in 47 subjects with moderate to severe knee osteoarthritis. No statistically significant differences were observed between bromelain and placebo groups for the primary outcome or quality-of-life measures, though both groups showed improvement in the WOMAC disability subscale.

PubMedRead on PubMed
2002·Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine·Marcus B Stone, Mark A Merrick, Christopher D Ingersoll, et al

Preliminary comparison of bromelain and Ibuprofen for delayed onset muscle soreness management.

RCTn = 39Physical Performance -

RCT comparing bromelain and ibuprofen for managing delayed onset muscle soreness in the elbow flexors. No differences among treatments were observed for pain, range of motion, or peak torque at any time point.

PubMedRead on PubMed
2001·Experimental neurology·D Lauer, A Reichenbach, G Birkenmeier

Alpha 2-macroglobulin-mediated degradation of amyloid beta 1--42: a mechanism to enhance amyloid beta catabolism.

RCTBrain Health

The study investigates the degradation of amyloid beta 1-42 by alpha 2-macroglobulin-proteinase complexes, including bromelain, trypsin, and alpha-chymotrypsin. Enhanced degradation of amyloid beta was observed ex vivo upon oral administration of high doses of proteinases, suggesting potential for reducing Alzheimer's disease risk by preventing amyloid beta accumulation.

PubMedRead on PubMed
2004·Burns : journal of the International Society for Burn Injuries·Lior Rosenberg, Oren Lapid, Alex Bogdanov-Berezovsky, et al

Safety and efficacy of a proteolytic enzyme for enzymatic burn debridement: a preliminary report.

Studyn = 130

A prospective, non-comparative study of a bromelain-derived debriding agent, Debridase, in 130 patients with deep second and third degree burns. Debridase showed effective debridement with no significant adverse events, suggesting it as a reliable enzymatic debriding agent for burns.

PubMedRead on PubMed
2002·Phytomedicine : international journal of phytotherapy and phytopharmacology·A F Walker, R Bundy, S M Hicks, et al

Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults.

Studyn = 77Joint Bone Health Inflammation Mood

Open, dose-ranging study of bromelain on mild acute knee pain in 77 healthy adults. Bromelain significantly reduced knee pain symptoms and improved psychological well-being, with greater effects at higher doses. Results suggest bromelain may ameliorate physical symptoms and improve well-being in a dose-dependent manner.

PubMedRead on PubMed
1999·Oncology reports·K Eckert, E Grabowska, R Stange, et al

Effects of oral bromelain administration on the impaired immunocytotoxicity of mononuclear cells from mammary tumor patients.

RCTn = 16Immunity

RCT studying the effects of oral bromelain on immunocytotoxicity in 16 breast cancer patients compared to healthy donors. Bromelain increased monocytic cytotoxicity in patients, suggesting potential antitumor activity. Bromelain also affected cell surface marker expression and cytokine secretion.

PubMedRead on PubMed
2013·The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology·Zahide Simşek, Akif Altınbaş, Tuncay Delibaşı, et al

Incomplete stomach emptying as a complication of intragastric balloon treatment and a solution suggestion: Pineapple juice drinking.

Observationaln = 19

The study investigated the effect of drinking pineapple juice on dissolving food remnants in patients undergoing endoscopic procedure for removal of intragastric balloon. Drinking pineapple juice for 3 days before the procedure was effective in dissolving food remnants in the stomach.

PubMedRead on PubMed
2013·PloS one·Jessica M Banks, Christine T Herman, Ryan C Bailey

Bromelain decreases neutrophil interactions with P-selectin, but not E-selectin, in vitro by proteolytic cleavage of P-selectin glycoprotein ligand-1.

In vitroInflammation

In vitro study examining the effect of bromelain on neutrophil interactions with selectins. Bromelain treatment reduced P-selectin-mediated tethering by cleaving PSGL-1, suggesting a mechanism for its anti-inflammatory effects.

PubMedRead on PubMed