Meta-Analysis the Efficacy of Turmeric (Curcuma domestica) in Reducing Pain in Patients of Knee Osteoarthritis

Authors

  • Danang Ardiyanto Masters Program in Public Health, Universitas Sebelas Maret
  • Didik Gunawan Tamtomo Faculty of Medicine, Universitas Sebelas Maret
  • Bhisma Murti Masters Program in Public Health, Universitas Sebelas Maret

Abstract

Background: Osteoarthritis (OA) of the knee joint has the highest prevalence among all types of rheumatic diseases. The most common symptom of knee OA is pain around the joint. Patients with OA require long treatment, especially using analgesic and anti-inflammatory drugs. Turmeric is efficacious as a pain reliever and anti-inflammatory. This study aims to estimate the magnitude of the effect of turmeric extract (Curcuma domestica) on pain in patients with knee OA compared to placebo and non-steroidal anti-inflammatory drugs (NSAIDs), based on the results of a number of previous similar studies.

Subjects and Method: This study is a systematic review and meta-analysis with the following PICO, population: patients with knee OA. Intervention: turmeric extract. Comparison: placebo and NSAIDs. Outcome: pain reduction. The articles used in this study were obtained from three databases, namely Google Scholar, Pubmed, and Science Direct. Keywords to search for articles: “Knee Osteoarthritis” OR “Knee OA” AND “Curcuma longa” OR “Curcuma domestica” OR “Turmeric extract” AND “Placebo” OR “NSAID” AND “pain” OR “visual analogue scale” OR “ VASE". The articles included are full-text with RCT study designs from 2011 to 2021. The selection of articles is carried out using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.3 application.

Results: A total of 15 RCT studies were selected for systematic review and meta-analysis. Data collected from 10 studies showed that patients with knee OA who received turmeric extract experienced 1.60 units lower joint pain than placebo (SMD= -1.60; 95% CI= -2.23 to -0.97; p<0.001). Data from 5 studies showed that patients with knee OA who received turmeric extract experienced 0.06 units higher joint pain than NSAIDs. The comparison between the turmeric extract group and the NSAID group did not show any significant difference (SMD= 0.06; 95% CI= -0.10 to -0.22; p= 0.490).

Conclusion: Administration of turmeric extract was more effective than placebo and not inferior to non-steroidal anti-inflammatory drugs in reducing pain in patients with knee OA.

Keywords: osteoarthritis, turmeric, pain

Correspondence: Danang Ardiyanto. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: drdanank@gmail.com. Mobile: 08122762579.

Indonesian Journal of Medicine (2021), 06(04): 364-376
https://doi.org/10.26911/theijmed.2021.06.04.02

References

Adatia A, Rainsford KD, Kean, WF (2012). Osteoarthritis of the knee and hip. Part I: aetiology and pathogenesis as a basis for pharmacotherapy. J Pharm Pharmacol. 64(5):617–625. doi.org/10.1111/J.20427158.2012.01458.X.

Atabaki M, ShariatiSarabi Z, TavakkolAfshari J, Mohammadi M (2020). Significant immunomodulatory properties of curcumin in patients with osteoarthritis; a successful clinical trial in Iran. Int Immunopharmacol. 85 (4): 596607. https://doi.org/10.1016/j.intimp.2020.106607.

Choi Y, Ban I, Lee H, Baik M (2019). Puffing as a novel process to enhance the antioxidant and antiinflammatory properties of Curcuma longa L. (turmeric). Mdpi.Com. https://doi.org/10.3390/antiox8110506.

Chu CR, Millis MB, Olson, SA (2014). Osteoarthritis: From palliation to prevention AOA critical issues. J Bone Joint Surg Am. 96(15): 130135. https://doi.org/10.2106/JBJS.M.01209.

Cooper C, Chapurlat R, AlDaghri, N, HerreroBeaumont G, Bruyère O, Rannou F, Roth R, et al. (2019). Safety of oral nonselective nonsteroidal antiinflammatory drugs in osteoarthritis: what does the literature say?. Drugs Deliv. 36(1): 15–24. https://doi.org/10.1007/s40266019006601.

Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H (2020). Global, regional prevalence, incidence and risk factors of knee osteoarthritis in populationbased studies. E Clinical Medicine. (1): 2933. https://doi.org/10.1016/j.eclinm.2020.100587.

Daily JW, Yang M, Park S (2016). Efficacy of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: a systematic review and metaanalysis of randomized clinical trials. J Med Food. 19(8):717–729. https://doi.org/10.1089/jmf.2016.3705.

Gomes TP, Souza JIN, Somerlate LC, Mendonça VA, Lima NM, Carli GP, Castro SBR, et al. (2021). Miconia albicans and Curcuma longa herbal medicines positively modulate joint pain, function and inflammation in patients with osteoarthritis: a clinical study. Inflammopharmacology. 29(2):377–391. doi.org/10.1007/s10787020007819.

Gupte PA, Giramkar SA, Harke SM, Kulkarni SK, Deshmukh AP, Hingorani L, Mahajan MP, Bhalerao SS (2019). Evaluation of the efficacy and safety of capsule longvida® optimized curcumin (solid lipid curcumin particles) in knee osteoarthritis: A pilot clinical study. J Inflam Res. (12):145–152. doi.org/10.2147/JIR.S205390.

Hashemzadeh K, Davoudian N, Jaafari MR, Mirfeizi Z (2019). The Effect of Nanocurcumin in Improvement of Knee Osteoarthritis: A Randomized Clinical Trial. Curr Rheumatol Rev. (2):158–164. https://doi.org/10.2174/1874471013666191223152658.

Henrotin Y, Malaise M, Wittoek R, De Vlam K, Brasseur JP, Luyten F, Jiangang Q, et al. (2019). Biooptimized Curcuma longa extract is efficient on knee osteoarthritis pain: A doubleblind multicenter randomized placebo controlled threearm study. Arth Res Ther. 21(1): 4550. https://doi.org/10.1186/S1307501919605.

Kertia N, Asdie AH, Rochmah W, Marsetyawan (2012). Ability of curcuminoid compared to diclofenac sodium in reducing the secretion of cycloxygenase2 enzyme by synovial fluid’s monocytes of patients with osteoarthritis. Acta Med Indones. 44(2): 105–113. http://www.inaactamedica.org/archives/2012/22745140.pdf.

Kuptniratsaikul V, Dajpratham P, Chootip C, Saengsuwan J, Tantayakom K, Laongpech S (2014). Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: A multicenter study. Clin Int Aging. 9: 451–458.https://doi.org/10.2147/cia.s58535.

Lee WH, Loo CY, Bebawy M, Luk F, Mason R, Rohanizadeh R. (2013). Curcumin and its Derivatives: Their Application in Neuropharmacology and Neuroscience in the 21st Century. Cur Neuropharm. 11(4):338–378. https://doi.org/10.2174/1570159X11311040002.

Li L, Zhang Y, Zeng C (2020). Update on the epidemiology, genetics, and therapeutic options of hyperuricemia. Am J of Trans Res. 12(7): 3137. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc7407685/.

Madhu K, Chanda K, Saji, MJ. (2013). Safety and efficacy of Curcuma longa extract in the treatment of painful knee osteoarthritis: A randomized placebocontrolled trial. J Inflam 21 (2): 129–136. https://doi.org/10.1007/s1078701201633.

Matsui H, Shimokawa O, Kaneko T, Nagano Y, Rai K, Hyodo I (2011). The pathophysiology of nonsteroidal antiinflammatory drug (NSAID)induced mucosal injuries in stomach and small intestine. J Clin Bio Nutri, 48(2):107–111. https://doi.org/10.3164/JCBN.1079.

Nakagawa Y, Mukai S, Yamada S, Matsuoka M, Tarumi E, Hashimoto T, Tamura C, Imaizumi A, Nishihira J, Nakamura T. (2014). Shortterm effects of highlybioavailable curcumin for treating knee osteoarthritis: a randomized, doubleblind, placebocontrolled prospective study. J Ortho Sci. 19(6):933–939. https://doi.org/10.1007/s0077601406330.

Panahi Y, Rahimnia AR, Sharafi M, Alishiri G, Saburi A, Sahebkar A (2014). Curcuminoid Treatment for Knee Osteoarthritis: A Randomized DoubleBlind PlaceboControlled Trial. Phyto Res. 28(11): 1625–1631. https://doi.org/10.1002/PTR.5174.

Panda SK, Nirvanashetty S, Parachur VA, Mohanty N, Swain T (2018). A Randomized, Double Blind, Placebo Controlled, ParallelGroup Study to Evaluate the Safety and Efficacy of Curene® versus Placebo in Reducing Symptoms of Knee OA. Bio Med Res Int.20(1): 5055. https://doi.org/10.1155/2018/5291945.

Pinzon RT, Sanyasi RD (2018). Curcuma longa for Arthritis pain: Systematic review of randomized controlled trial study. Asian J Pharm 4(5): 528–534. https://doi.org/10.31024/ajpp.2018.4.5.1.

Riskesdas (2019). Laporan hasil Riset Kesehatan Dasar (RISKESDAS) Nasional. Badan Penelitian dan Pengembangan Kesehatan Kemenkes RI. https://www.litbang.kemkes.go.id/laporanrisetkesehatandasarriskesdas/.

SharifiRad J, Rayess Y, El Rizk AA, Sadaka C, Zgheib R, Zam W, Sestito S, et al. (2020). Turmeric and Its Major Compound Curcumin on Health: Bioactive Effects and Safety Profiles for Food, Pharmaceutical, Biotechnological and Medicinal Applications.Front Pharmacol. 11(11): 1–23. https://doi.org/10.3389/fphar.2020.01021.

Shep D, Khanwelkar C, Gade P, Karad S. (2019). Safety and efficacy of curcumin versus diclofenac in knee osteoarthritis: A randomized openlabel parallelarm study. Trials. 20 (1): 1–11.

Srivastava S, Saksena AK, Khattri S, Kumar S, Dagur RS (2016). Curcuma longa extract reduces inflammatory and oxidative stress biomarkers in osteoarthritis of knee: a fourmonth, doubleblind, randomized, placebocontrolled trial. Inflammopharmacology,

(6): 377–388. https://doi.org/10.1007/s1078701602899.

Teymouri S, Rakhshandeh H, Baghdar H, Yousefi M, Salari R (2019). Analgesic herbal medicines in the treatment of knee osteoarthritis: A systematic review. Curr Rheumatol Rev. 15(4): 290–303. https://doi.org/10.2174/1573397115666190328150203.

Verma RK, Kumari P, Maurya RK, Kumar V, Verma RB, Singh RK (2018). Medicinal properties of turmeric (Curcuma longa L.): A review. Int J Chem Study. 6 (4): 1354–1357. https://www.chemijournal.com/archives/?year=2018&vol=6&issue=4&ArticleId=3186&si=false.

Wang Z, Jones G, Winzenberg T, Cai G, Laslett LL, Aitken D, Hopper I, Singh A, Jones R, et al. (2020). Effectiveness of Curcuma longa Extract for the Treatment of Symptoms and EffusionSynovitis of Knee Osteoarthritis: A Randomized Trial. Ann Int Med. 173 (11): 861–869. https://doi.org/10.7326/M200990.

Downloads

Published

2022-02-15

Issue

Section

Articles