Efficacy and safety of Curcuma longa extract as a treatment of primary knee osteoarthritis in adults and elderly: a systematic review

Main Article Content

Ana Gutiérrez Ruiz
Ismael San Mauro Martin
Elena Garicano Vilar
Cristian Brata
Maria Alicia Camina Martín

Keywords

curcumin, Curcuma longa, osteoarthritis, knee, treatment

Abstract

Osteoarthritis (OA) is a chronic disease that leads to the wearing of joints cartilage, the most common being knee OA. The aim was to idetify the efficacy and safety of Curcuma longa extract as a potential treatment for knee OA in adults and elderly.


A systematic review was conducted on different databases, using a search strategy that included curcumin, curcuma, turmeric, dietary/food/herbal supplement, phytochemical, plant extract, nutraceutical and osteoarthritis as keywords. Inclusion criteria were double-parallel randomized clinical trials in adults, diagnosed with knee OA, and published within the last 10 years. Only studies that used turmeric, not any other herbaceous substance, were included.


Five studies were included. VAS, WOMAC, JKOM and KOOS scales were used. Inflammation and oxidative stress and cartilage degradation biomarkers were controlled. Statistically significant reductions in VAS, WOMAC (except stiffness) and biomarkers were observed.


Curcumin may have therapeutic utility in knee OA, showing similar efficacy to conventional drug treatment, but presenting fewer adverse effects.

Abstract 695 | PDF Downloads 414

References

[1] Ameye LG, Chee WSS. Osteoarthritis and nutrition. From nutraceuticals to functional foods: A systematic review of the scientific evidence. Arthritis Res Ther 2006;8:R127. https://doi.org/10.1186/ar2016.
[2] Martínez Figueroa R, Martínez Figueroa C, Calvo Rodriguez R, Figueroa Poblete D. Osteoartritis (artrosis) de rodilla. Rev Chil Ortop y Traumatol 2015;56:45–51. https://doi.org/10.1016/j.rchot.2015.10.005.
[3] Carmona L. Epidemiology of rheumatoid arthritis. Rev Española Reumatol 2002;29:86–90.
[4] Belmonte Serrano MA, Beltrán Fabregat J, Lerma Garrido J. Artrosis. In: Belmonte, Castellano, Roman, Rosas, editor. Enfermedades Reumáticas. 2nd editio, Ibañez&Plaza; 2013, p. 705–28.
[5] Haq I, Murphy E, Dacre J. Osteoarthritis. Postgrad Med J 2003;79:377–383. https://doi.org/10.1136/pmj.79.933.377.
[6] Oliver J. Manual SER. Madrid: Editorial Panamericana; 2013. https://doi.org/10.1017/CBO9781107415324.004.
[7] Bellamy N, Wilson C, Hendrikz J. Population-Based Normative Values for the Western Ontario and McMaster (WOMAC) Osteoarthritis Index: Part I. Semin Arthritis Rheum 2011;41:139–48. https://doi.org/10.1016/j.semarthrit.2011.03.002.
[8] Akai M, Doi T, Fujino K, Iwaya T, Kurosawa H, Nasu T. An outcome measure for Japanese people with knee osteoarthritis. J Rheumatol 2005;32:1524–32.
[9] Roos EM, Lohmander LS. The Knee injury and Osteoarthritis Outcome Score (KOOS): From joint injury to osteoarthritis. Health Qual Life Outcomes 2003;1:64. https://doi.org/10.1186/1477-7525-1-64.
[10] Wittenauer R, Smith L, Aden K. Background Paper 6.12 Osteoarthritis. 2013. https://doi.org/10.1007/SpringerReference_39322.
[11] Blagojevic M, Jinks C, Jeffery A, Jordan KP. Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthr Cartil 2010;18:24–33. https://doi.org/10.1016/j.joca.2009.08.010.
[12] Hernandez Huesca K. Caracterización y digestión gastrointestinal de cápsulas líquidas de curcumina (Curcuma longa L.). Universidad Veracruzana, 2016.
[13] Saiz de Cos P. Cúrcuma I (Curcuma longa L.). REDUCA (Biología) 2014;7:84–99.
[14] Onakpoya IJ, Spencer EA, Perera R, Heneghan CJ. Effectiveness of curcuminoids in the treatment of knee osteoarthritis: a systematic review and meta-analysis of randomized clinical trials. Int J Rheum Dis 2017;20:420–33. https://doi.org/10.1111/1756-185X.13069.
[15] Mesa MD, Ramirez-Tortosa MC, Aguilera CM, Ramirez-Boscá A, Gil A. Pharmacological and nutritional effects of Curcuma longa L. extracts and curcuminoids. Ars Pharm 2000;41:307–21.
[16] Hewlings S, Kalman D. Curcumin: A Review of Its’ Effects on Human Health. Foods 2017;6:92. https://doi.org/10.3390/foods6100092.
[17] Kuptniratsaikul V, Dajpratham P, Taechaarpornkul W, Buntragulpoontawee M, Lukkanapichonchut P, Chootip C, et al. Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: A multicenter study. Clin Interv Aging 2014;9:451–8. https://doi.org/10.2147/cia.s58535.
[18] Srivastava S, Saksena AK, Khattri S, Kumar S, Dagur RS. Curcuma longa extract reduces inflammatory and oxidative stress biomarkers in osteoarthritis of knee: a four-month, double-blind, randomized, placebo-controlled trial. Inflammopharmacology 2016;24:377–88. https://doi.org/10.1007/s10787-016-0289-9.
[19] Panda SK, Nirvanashetty S, Parachur VA, Mohanty N, Swain T. A Randomized, Double Blind, Placebo Controlled, Parallel-Group Study to Evaluate the Safety and Efficacy of Curene® versus Placebo in Reducing Symptoms of Knee OA. Biomed Res Int 2018:e5291945. https://doi.org/10.1155/2018/5291945.
[20] Nakagawa Y, Mukai S, Yamada S, Matsuoka M, Tarumi E, Hashimoto T, et al. Short-term effects of highly-bioavailable curcumin for treating knee osteoarthritis: a randomized, double-blind, placebo-controlled prospective study. J Orthop Sci 2014;19:933–9. https://doi.org/10.1007/s00776-014-0633-0.
[21] Henrotin Y, Malaise M, Wittoek R, De Vlam K, Brasseur JP, Luyten FP, et al. Bio-optimized Curcuma longa extract is efficient on knee osteoarthritis pain: A double-blind multicenter randomized placebo controlled three-arm study. Arthritis Res Ther 2019;21:e179. https://doi.org/10.1186/s13075-019-1960-5.
[22] da Costa BR, Nüesch E, Kasteler R, Husni E, Welch V, Rutjes AWS, et al. Oral or transdermal opioids for osteoarthritis of the knee or hip. Cochrane Database Syst Rev 2014;17:CD003115. https://doi.org/10.1002/14651858.CD003115.pub4.
[23] FDA. U.S. Food and Drug Administration n.d. https://www.fda.gov/ (accessed June 12, 2020).
[24] Ameye LG, Chee WSS. Osteoarthritis and nutrition. From nutraceuticals to functional foods: A systematic review of the scientific evidence. Arthritis Res Ther 2006;8:R127. https://doi.org/10.1186/ar2016.
[25] Beltrán K, Garrido L. Artrosis. In: Belmonte MA, Castellano JA, Román JA, Rosas J, editors. Enfermedades reumáticas. 2nd ed., Madrid: Ibañez&Plaza; 2013, p. 705–28.
[26] Lozada C. Osteoarthritis: Practice Essentials, Background, Anatomy. Medscape 2020. https://emedicine.medscape.com/article/330487-overview#a4 (accessed June 17, 2020).
[27] Toegel S, Wu SQ, Piana C, Unger FM, Wirth M, Goldring MB, et al. Comparison between chondroprotective effects of glucosamine, curcumin, and diacerein in IL-1β-stimulated C-28/I2 chondrocytes. Osteoarthr Cartil 2008;16:1205–12. https://doi.org/10.1016/j.joca.2008.01.013.
[28] Shakibaei M, Schulze-Tanzil G, John T, Mobasheri A. Curcumin protects human chondrocytes from IL-1β-induced inhibition of collagen type II and β1-integrin expression and activition of caspase-3: An immunomorphological study. Ann Anat 2005;187:487–97. https://doi.org/10.1016/j.aanat.2005.06.007.
[29] European Food Safety Authority. Curcumin and normal functioning of joints: evaluation of a health. EFSA J 2017. https://doi.org/10.2903/j.efsa.2017.4774.

Most read articles by the same author(s)