Abstract
BackgroundThe purpose of this study was to compare the efficacy and safety of curcumin with those of diclofenac in the treatment of knee osteoarthritis (OA).MethodsIn this randomized, open-label, parallel, active controlled clinical study, 139 patients with knee OA were randomly assigned to receive either a curcumin 500-mg (BCM-95®) capsule three times daily or a diclofenac 50-mg tablet two times daily for 28 days. Patients underwent assessment at baseline and days 7, 14, and 28. The main outcome measure was severity of pain using visual analogue scale score at days 14 and 28. Knee Injury and Osteoarthritis Outcome Score (KOOS) (at days 14 and 28), anti-flatulent effect (at day 7), anti-ulcer effect, weight-lowering effect, and patient’s and physician’s global assessment of therapy at day 28 were included as secondary outcome measures. Safety after treatment was evaluated by recording adverse events and laboratory investigation.ResultsAt days 14 and 28, patients receiving curcumin showed similar improvement in severity of pain and KOOS scale when compared with diclofenac, and the difference was not statistically significant. At day 7, the patients who received curcumin experienced a significantly greater reduction in the number of episodes of flatulence compared with diclofenac (P <0.01). At day 28, a weight-lowering effect (P <0.01) and anti-ulcer effect (P <0.01) of curcumin were observed. None of the patients required H2 blockers in the curcumin group, and 19 patients required H2 blockers in the diclofenac group (0% versus 28%, respectively; P <0.01). Adverse effects were significantly less in the curcumin group (13% versus 38% in the diclofenac group; P <0.01). Patient’s and physician’s global assessment of therapy was similar in the two treatment groups.ConclusionCurcumin has similar efficacy to diclofenac but demonstrated better tolerance among patients with knee OA. Curcumin can be an alternative treatment option in the patients with knee OA who are intolerant to the side effects of non-steroidal anti-inflammatory drugs.Trial registrationISRCTN, ISRCTN10074826. Registered 21 November 2017 - Retrospectively registered.
Highlights
The purpose of this study was to compare the efficacy and safety of curcumin with those of diclofenac in the treatment of knee osteoarthritis (OA)
Usual first-line pharmacologic therapy for knee OA consists of non-steroidal anti-inflammatory drugs (NSAIDs), which provide effective relief of symptoms in most patients [12, 13]
We investigated the antiflatulent and weight-lowering effects of curcumin among patients with knee OA and compared them with those of diclofenac
Summary
The purpose of this study was to compare the efficacy and safety of curcumin with those of diclofenac in the treatment of knee osteoarthritis (OA). Symptoms of knee OA normally begin after the age of 40 years but can affect younger people after a traumatic injury It is highly prevalent among obese patients, and the estimated incidence is 10% to 15% in the population above 60 years of age [1, 2]. Pharmacological therapy with NSAIDs offers temporary relief in symptoms but is associated with serious risk after long-term use. Chronic administrations of NSAIDs cause gastroduodenal mucosal erosions in about 35–60% of patients and gastric or duodenal ulceration in 10–25% of patients [14]. These events are a consequence of a non-selective mechanism of action of traditional NSAIDs [13]. There is a need for an effective and safer alternative treatment for knee OA
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