Safety and efficacy of Curcuma longa extract in the treatment of painful knee osteoarthritis: a randomized placebo-controlled trial

Abstract

Curcuma longa Linn. is widely used for the treatment of disorders associated with inflammation and was evaluated for its safety and efficacy in the treatment of painful knee osteoarthritis (OA). This was a randomized, single blind, placebo-controlled trial. Total of 120 patients (37 males and 83 females) with primary knee OA received either placebo (400 mg twice daily) or NR-INF-02 (500 mg twice daily) or glucosamine sulphate (GS) (750 mg twice daily) alone or combination of NR-INF-02 and GS for 42 days. The efficacy was assessed during treatment period, on day 21 and day 42. The decrease in severity of pain symptom and function of affected knee as primary efficacy outcome measure was assessed by Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale, respectively. The clinical examination of affected joint was measured by an orthopaedic specialist and using a Clinician Global Impression Change (CGIC) scale. The analysis of post-treatment scores following administration of NR-INF-02 using VAS, WOMAC, and CGIC at each clinical visit showed significant decrease (p < 0.05) compared to placebo. NR-INF-02 treated group showed a significant (p < 0.01) decrease in use of rescue medication, along with clinical and subjective improvement compared to placebo. The tolerability and acceptability profile of NR-INF-02 was better during the trial period. The study demonstrates safety and efficacy of NR-INF-02 as a useful treatment option for patients with primary painful knee OA.

Effectiveness of curcuminoids in the treatment of knee osteoarthritis: a systematic review and meta‐analysis of randomized clinical trials

“…37 We also excluded one study because there was no relevant outcome 38 and one (abstract) because it was a duplicate of another excluded study. 39 Finally, we included seven studies [40][41][42][43][44][45][46] with a total of 797 participants. Key details of the included studies are shown in Table 1.…”

“…In four studies the proportion of participants with bilateral knee OA ranged from 37% 44 to 100%. 45 Three studies 42,43,46 did not report the proportion of participants with bilateral knee OA. The mean age of the participants ranged from 57 to 69 years, and the duration of intervention was between 4 and 16 weeks.…”

“…The mean age of the participants ranged from 57 to 69 years, and the duration of intervention was between 4 and 16 weeks. The duration of symptoms was approximately 20 months in one study 40 and 12 months in another 41 ; a third study 42 included participants with at least 6 months duration of symptoms. Four studies [43][44][45][46] did not report the duration of OA symptoms for their study participants.…”

“…Three studies 40,41,46 used similar methods to extract curcuminoids; however, the concentration of pure curcumin was between 75% and 85% in two studies, 40,41 while the concentration was reported as ≥ 95% in the third. 46 One study 42 used polysaccharide to enhance the bioavailability of curcuminoids, another 45 combined curcuminoids with Bioperineâ to enhance bioavailability, while another 44 used surface-controlled water-dispersible curcumin to increase the bioavailability. The method used to extract curcuminoids in one study 43 was unclear.…”

“…Five studies [42][43][44][45][46] used a placebo as comparator, while ibuprofen was used as the comparator in two studies. 40,41 Rescue medications used were tramadol, 41 acetaminophen, 42 celecoxib or pain relief patches 44 and naproxen.…”