Evidence Trace, complete trial record

In plain terms

In plain terms: Serrapeptase (Serratiopeptidase) has not yet been tested in a human trial designed to measure the outcome relevant here. The available human research does not yet answer the question.

Serrapeptase (Serratiopeptidase)

D Not shown: no human trial shows benefit

Route 1 — no qualifying human trial has been conducted

Category Supplements

Evidence Small randomized trials, narrow postoperative indications only

Reviewed October 2026

PMIDs 33653320 · 6366808 · 18272344 · 19168326 · 2688125 · 23380245

The endpoint this grade is based on: Surrogate biomarker endpoint, Swelling after oral or sinus surgery, on five small randomized trials of mixed result; no trial has tested systemic, cardiovascular or longevity use

The evidence as the record states it

Evidence record

PMID 33653320 PMID 6366808 PMID 18272344 PMID 19168326 PMID 2688125 PMID 23380245

Graded by use. Postoperative swelling: Tachibana et al. (Pharmatherapeutica, 1984; PMID 6366808): double-blind placebo-controlled trial, 174 patients after Caldwell-Luc sinus surgery; buccal swelling less at every postoperative time point. Al-Khateeb and Nusair (Int J Oral Maxillofac Surg, 2008; PMID 18272344): randomized double-blind crossover trial, 24 patients, third molar surgery; cheek swelling and pain less on days 2, 3 and 7, mouth opening not different. Tamimi et al. (BMC Oral Health, 2021; PMID 33653320): randomized controlled trial, 133 patients, third molar surgery; swelling and trismus improved, pain not different. Kee et al. (Singapore Med J, 1989; PMID 2688125): randomized double-blind trial, 70 women with breast engorgement; pain, swelling and induration improved against placebo. Chopra et al. (Int J Oral Maxillofac Surg, 2009; PMID 19168326): randomized five-arm trial, 150 patients, third molar surgery; serratiopeptidase showed no significant analgesic or anti-inflammatory effect. Bhagat et al. (Int J Surg, 2013; PMID 23380245): systematic review; the trials are few, small and of poor methodology, and the evidence is insufficient to support use as an analgesic or health supplement. Grade C for postoperative swelling: four positive and one null small trials. Grade D, Route 1, for systemic inflammation, cardiovascular and longevity use: no randomized trial has tested any of them.

PMID 33653320 PMID 6366808 PMID 18272344 PMID 19168326 PMID 2688125 PMID 23380245

Evidence by specific use

Swelling after oral or sinus surgery

Grade C

Four small randomized placebo-controlled trials found less swelling (Tachibana 1984, n=174; Al-Khateeb 2008, n=24; Tamimi 2021, n=133; Kee 1989, breast engorgement, n=70) and one found no effect (Chopra 2009, n=150). Pain results are split: Al-Khateeb and Kee found less, Tamimi and Chopra did not. A 2013 systematic review (Bhagat, PMID 23380245) rates the trials small and poorly designed. Small, mixed, short-term human trials are C.

PMID 6366808 PMID 18272344 PMID 33653320 PMID 2688125 PMID 19168326 PMID 23380245

Systemic inflammation, cardiovascular or longevity use

Grade D

No randomized trial has tested serrapeptase for any systemic, cardiovascular or longevity outcome. The eleven randomized trials of the enzyme all address short-term surgical and ENT swelling. The 2013 systematic review (PMID 23380245) found the evidence insufficient to support use as a health supplement and noted that long-term safety data are lacking.

PMID 23380245

Animal lifespan data and mechanistic plausibility are excluded from EBL grades by rule. They inform the scientific rationale but do not carry the letter.

Why Grade D Route 1 and not Grade C

Grade D Route 1 applies when no qualifying human randomized trial has tested this compound or intervention against the relevant endpoint. Absence confirmed: (serrapeptase[tiab] OR serratiopeptidase[tiab]) AND randomized controlled trial[pt] AND (longevity[tiab] OR aging[tiab] OR mortality[tiab] OR "cardiovascular"[tiab] OR atherosclerosis[tiab] OR "chronic inflammation"[tiab]) (PubMed, August 2026)

The first qualifying human RCT with a meaningful endpoint would move this to Grade C or higher, depending on what it shows.

What would move this grade

The first qualifying randomized controlled trial in humans, testing this intervention against a meaningful aging-relevant endpoint, would initiate grading. Depending on the result, it could land at any grade from A to D.

How to track whether this is working No validated human outcome to track for the uses it is sold for. In the surgical trials the measured outcome was cheek swelling by caliper or tape over the first postoperative week.