Real-world experience with Curcumin-QingDai combination for patients with active ulcerative colitis: A retrospective multicentre cohort study.

Abstract

Curcumin and QingDai (QD, Indigo) were shown effective for treating active ulcerative colitis (UC). We aimed to evaluate the real-world experience with the Curcumin-QingDai (CurQD) herbal combination to induce remission in active UC. A retrospective multicentre adult cohort study from five tertiary academic centres (2018-2022). Active UC was defined as a Simple Clinical Colitis Activity Index (SCCAI) ≥ 3. Patients were induced by CurQD. The primary outcome was clinical remission at weeks 8-12, defined as SCCAI ≤2 and a decrease ≥3 points from baseline. clinical response (SCCAI decrease ≥3 points), corticosteroid-free remission, faecal calprotectin (FC) response (reduction ≥50%), FC normalisation (FC ≤100 μg/g for patients with FC ≥300 μg/g at baseline) and safety. All outcomes were analysed for patients who were maintaining stable treatment. Eighty-eight patients were included; 50% were biologics/small molecules experienced, and 36.5% received ≥2 biologics/small molecules. Clinical remission was achieved by 41/88 (46.5%), and clinical response by 53/88 (60.2%). The median SCCAI decreased from 7 (IQR:5-9) to 2 (IQR:1-3), p < 0.0001. Of the 26 patients on corticosteroids at baseline, seven (26.9%) patients achieved corticosteroid-free remission. Among 43 biologics/small molecules experienced patients, clinical remission was achieved in 39.5% and clinical response by 58.1%. FC normalisation and response were achieved in 17/29 (58.6%) and 27/33 (81.8%) respectively. Median FC decreased from 1000 μg/g (IQR:392-2772) at baseline to 75 μg/g (IQR:12-136) at the end of inductions (n = 30 patients with paired samples), p < 0.0001. No overt safety signals emerged. In this real-world cohort, CurQD effectively induced clinical and biomarker remission in patients with active UC, including the biologics/small molecules experienced patients.