1. Curcumin Supplementation for Relief of Pain Associated With Osteoarthritis
Kelly Schatzlein PA-S and Keely Tietjen PA-S
James Madison University, Harrisonburg ,VA
INTRODUCTION
RESULTS
RESULTS
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Study #1: Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study. Kuptniratsaikul, V. et al 2014
Osteoarthritis (OA) is a degenerative joint disease that affects nearly 27 million Americans and is characterized by joint pain, stiffness, and restricted movement. Current treatment modalities include lifestyle changes, pharmacological treatment, and surgical intervention. Pharmacological treatments include nonsteroidal anti-inflammatory drugs (NSAIDs), opioid analgesics, and intraarticular injections. Currently, NSAIDs are the agent of choice for pain management long term. However, NSAIDs are associated with gastrointestinal, renal, and cardiovascular symptoms. This has led to an increased interest in herbal supplements for the treatment of OA, including Curcumin. Curcumin has been found to be safe and tolerable in humans and it is capable of inhibiting pro-inflammatory mediators frequently seen in the development of OA. To date, there is limited research on the effects of Curcumin on symptom relief for osteoarthritis; however, research may suggest Curcumin to have the same effect as NSAIDs with limited gastrointestinal side effects.
Study Type: Double blind randomized control trial
Study Type: Double Blind Randomized control trial
Sample Size: 367
Length of Program: 4 weeks
Objective To determine the efficacy of cercuma compared to ibuprofen in reducing pain of OA symptoms and improving function.
Conclusion: Cercuma is as effective as ibuprofen in reducing OA symptoms and has a better safety profile with reduced GI symptoms compared to ibuprofen treatment
Critique: Strengths: standardized administration of capsules, large sample size. Limitations: Short study duration, use of rescue medication for severe symptoms, mostly female subjects
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PICO
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CONCLUSIONS
Study #2: Curcuma longa extract reduces inflammatory and oxidative stress biomarkers in osteoarthritis of knee: a four-month, double-blind, randomized, placebo-controlled trial
Population
Adults (> 40 years old) with osteoarthritis
Intervention
Curcumin
Comparison
Ibuprofen, placebo, placebo plus Diclofenac
Outcome
Patient’s functional improvement of OA symptoms
OBJECTIVES HERE
To determine if curcumin supplementation compared to NSAIDs, placebo and rescue medications is an effective treatment of arthritic symptoms in males and females over the age of 40 with a diagnosis of osteoarthritis.  
Based on the results of three small double blinded trials, curcumin may be an effective alternative to NSAIDs in controlling pain associated with osteoarthritis symptoms with limited GI side effects. Therefore, curcumin may be a reasonable alternative to patient who cannot tolerate NSAIDs due to the GI and cardiovascular adverse effects. However, due to the lack of research to date  the use of curcumin in the treatment of OAadditional studies are needed before a definitive recommendation can be made to the general population for its usefulness in pain relief in patients with OA. Future studies should include larger population based studies, with longer duration of supplementation to better assess the general population as a whole and the long term effectiveness of curcumin. Further additional studies should limit the use of rescue medications to specifically determine if curcumin is effective alone in controlling the pain.
Study Type: Double Blind Randomized control trial
Sample Size: 133
Length of Program: 4 months
Objective: To evaluate the efficacy of cercuma when co-administered with Diclofenac compared to Diclofenac co-administered with placebo, in alleviating OA symptoms and decreasing inflammatory markers as evidenced on laboratory findings.
Conclusion: Adjuvant treatment of cercuma with diclofenac produces a greater reduction in joint crepitation, joint stiffness, and joint effusion compared to participants treated with diclofenac alone.
Critique: Strengths: Objective assessment of OA, including biomarkers of inflammation, extensive follow-up. Limitations: small sample size, concurrent use of diclofenac in cercuma group.
METHODS
ACKNOWLEDGMENTS
We would like to thank Dr. Erika Kancler, Carolyn Schubert, and the communication center for their time and assistance with this research project.
Study #3:Curcuminoid Treatment for Knee Osteoarthritis: A Randomized Double-Blind Placebo-Controlled Trial
REFERENCES
Sample Size: 40
Length of Program:
Objective: To determine the efficacy of curcuminoids in alleviating OA symptoms when co-administered with Bioperine, an extract that enhances absorption.
Conclusion: Patient in the Bioperine group had a statistically significant reduction in OA symptoms as measured by the WOMAC score compared to control group.
Critique: Strengths: Enhanced bioavailability of curcumin, Limitations: small sample size
1. Kuptniratsaikul V, Dajpratham P, Taechaarpornkul W, Buntragulpootawee M, Lukkanapichonchut P, Chootip C, Saengsuwan J, Tantayakom K, Laongpech S.  
2. 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(6): doi: /s Panahi Y, Rahimnia AR, Sharafi M, Alishiri G, Saburi A, Sahebkar, A. Curcuminoid Treatment for Knee Osteoathritis: A Randomized Double-Blind Placebo-Controlled Trial. Phytotherapy Research. 2014; (28) /1/17. CES HERE
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