"Background: To compare the efficacy and safety of bioavailable turmeric extract versus paracetamol in patients with knee osteoarthritis (OA).
Methods: In this randomized, non-inferiority, controlled clinical study, patients of knee OA were randomized to receive bioavailable turmeric extract (BCM-95®) 500 mg capsule two times daily or paracetamol 650 mg tablet three times daily for 6 weeks. The primary outcome measure was Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale. The secondary outcome measures were WOMAC total, WOMAC stiffness, and WOMAC physical function scores. Responder analysis of individual patients at different levels (≥ 20%, ≥ 50%, and ≥ 70%) for WOMAC score was calculated. TNF alpha and CRP levels were evaluated and adverse events (AE) were also recorded.
Results: Seventy-one and seventy-three knee OA patients, respectively in bioavailable turmeric extract and paracetamol groups, completed the study. Non-inferiority (equivalence) test showed that WOMAC scores were equivalent in both the groups (p value < 0.05) in all the domains within the equivalence limit defined by effect size (Cohen's d) of 0.5 whereas CRP and TNF-α were better reduced with turmeric extract than paracetamol. After 6 weeks of treatment, WOMAC total score, pain, stiffness, and function scores got a significant improvement of 23.59, 32.09, 28.5, and 20.25% respectively with turmeric extract. In the turmeric extract group, 18% of patients got more than 50% improvement and 3% of patients got more than 70% improvement in WOMAC pain and function/stiffness score and none of the patients in the paracetamol group met the criteria. CRP and TNF-α got significantly reduced (37.21 and 74.81% respectively) in the turmeric extract group. Adverse events reported were mild and comparatively less in the turmeric extract group (5.48%) than in the paracetamol group (12.68%).
Conclusion: The results of the study suggest that bioavailable turmeric extract is as effective as paracetamol in reducing pain and other symptoms of knee osteoarthritis and found to be safe and more effective in reducing CRP and TNF-α."
- Singhal S, Hasan N, Nirmal K, Chawla R, Chawla S, Kalra BS, Dhal A. Bioavailable turmeric extract for knee osteoarthritis: a randomized, non-inferiority trial versus paracetamol. Trials. 2021 Jan 30;22(1):105. doi: 10.1186/s13063-021-05053-7. PMID: 33516238; PMCID: PMC7847013.*
"The wisdom and scientific credentials of curcumin in the Ayurvedic and Chinese systems of medicine have been corroborated by numerous studies conducted over the past 30 years. These observations are also supported by epidemiological data suggesting lower incidence of chronic diseases in people from countries where curcumin is consumed. The various effects of curcumin has been widely studied in Western systems of medicine for decades, and has been found to possess antioxidant and anti-inflammatory activities. Considering that inflammation plays a major role in most chronic illnesses, anti-inflammatory agents are needed for prevention purposes. Although several different steroids and NSAIDS (such as celecoxib, aspirin, ibuprofen, phenylbutazole, etc) have been approved for treatment of inflammatory conditions, most of them have side effects, especially when consumed over long periods of time. Because curcumin inhibits multiple proinflammatory pathways and is affordable, this phytochemical should be further explored for prevention and treatment of various chronic diseases. Further clinical trials are needed to fully develop the potential of this “age-old NSAID”."
- Aggarwal BB, Harikumar KB. Potential therapeutic effects of curcumin, the anti-inflammatory agent, against neurodegenerative, cardiovascular, pulmonary, metabolic, autoimmune and neoplastic diseases. Int J Biochem Cell Biol. 2009 Jan;41(1):40-59. doi: 10.1016/j.biocel.2008.06.010. Epub 2008 Jul 9. PMID: 18662800; PMCID: PMC2637808.*
"Background: The dietary spice Curcuma longa, also known as turmeric, has various biological effects. Both a water extract and a supercritical carbon dioxide extract of C. longa showed anti-inflammatory activities in animal studies. However, the anti-inflammatory effect in humans of a mixture of these two C. longa extracts (CLE) is poorly understood. Therefore, we investigated the effect of CLE containing anti-inflammatory turmeronols on chronic inflammation and general health.
Methods: We performed a randomized, double-blind, placebo-controlled study in healthy subjects aged 50 to 69 years with overweight. Participants took two capsules containing CLE (CLE group, n = 45) or two placebo capsules (placebo group, n = 45) daily for 12 weeks, and serum inflammatory markers were measured. Participants also completed two questionnaires: the Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36) and the Profile of Mood States (POMS) scale. Treatment effects were analyzed by two way analysis of variance followed by a t test (significance level, p < 0.05).
Results: After the intervention, the CLE group had a significantly lower body weight (p < 0.05) and body mass index (p < 0.05) than the placebo group and significantly lower serum levels of C-reactive protein (p < 0.05) and complement component 3 (p < 0.05). In addition, the CLE group showed significant improvement of the MOS SF-36 mental health score (p < 0.05) and POMS anger-hostility score (p < 0.05).
Conclusion: CLE may ameliorate chronic low-grade inflammation and thus help to improve mental health and mood disturbance."
- Uchio R, Kawasaki K, Okuda-Hanafusa C, Saji R, Muroyama K, Murosaki S, Yamamoto Y, Hirose Y. Curcuma longa extract improves serum inflammatory markers and mental health in healthy participants who are overweight: a randomized, double-blind, placebo-controlled trial. Nutr J. 2021 Nov 13;20(1):91. doi: 10.1186/s12937-021-00748-8. PMID: 34774052; PMCID: PMC8590273.*
"This proof-of-concept study showed that curcuma decreases serum hepcidin levels in humans and supports the idea that curcuma could be used to treat hepcidin over-production during inflammatory processes. The low cost of curcuma makes it attractive for a worldwide use. A phase 2 study is now required in patients with chronic inflammation such as inflammatory rheumatologic disease to determine the optimal dose and therapeutic scheme of curcuma before confirmatory studies."
- Lainé F, Laviolle B, Bardou-Jacquet E, Fatih N, Jezequel C, Collet N, Ropert M, Morcet J, Hamon C, Reymann JM, Loréal O. Curcuma decreases serum hepcidin levels in healthy volunteers: a placebo-controlled, randomized, double-blind, cross-over study. Fundam Clin Pharmacol. 2017 Oct;31(5):567-573. doi: 10.1111/fcp.12288. Epub 2017 May 7. PMID: 28370178.*
