When combined with mesalamine therapy, curcumin, a natural phytochemical derived from turmeric, was superior to placebo in inducing clinical and endoscopic remission in patients with mild-to-moderate ulcerative colitis, according to results from a double-blind randomized controlled trial.
Between July 2011 and June 2014, researchers enrolled 50 patients with mild-to-moderate active UC despite maximal mesalamine treatment from three medical centers in Israel, Hong Kong and Cyprus. Patients’ mesalamine treatments were either already optimized (n = 34; 4 g per day oral mesalamine plus 1 g topical mesalamine/4 g enema or 1 g suppository per day) or were escalated during a 2-week run-in period for optimization. Patients were then randomly assigned to receive 1 month add-on of 3 g oral curcumin capsules (n = 26; three capsules twice per day before meals) or placebo.
In the intention-to-treat analysis, 53.8% of patients in the curcumin group achieved clinical remission after 1 month of treatment compared with none of the patients in the placebo group (OR = 42.2; 95% CI, 2.3-760), and 65.3% vs. 12.5% achieved clinical improvement (OR = 13.2; 95% CI, 3.1-56.6). Of the 38 patients who underwent endoscopic evaluation before and after treatment (curcumin group, n = 22), 36.3% of the curcumin group achieved endoscopic remission compared with none of the placebo group (OR = 20.7; 95% CI, 1.1-393). Adverse events were uncommon and similar between groups.
“The findings of this trial suggest that curcumin as add-on therapy with optimized mesalamine is superior to optimized mesalamine alone in inducing clinical remission in patients with active mild-to-moderate UC,” the researchers concluded, adding that further studies are warranted.
Charles N. Bernstein
These investigators “have tackled an important therapeutic need in UC, a well-tolerated, inexpensive, oral therapy in mild-to-moderate UC, resistant to mesalamine,” Charles N. Bernstein, MD, from the University of Manitoba IBD Clinical and Research Center, wrote in a related editorial. “Furthermore, they have studied a widely available agent that has at least some track record of study in UC. Their results suggest that a large phase 2 to 3 study is warranted. First, however, a comparable placebo must be developed to ensure that participants and providers can truly remain blinded throughout the study.” – by Adam Leitenberger
Disclosure: Lang reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures. Bernstein reports he has served on the advisory boards for AbbVie Canada, Shire Canada, Takeda Canada, Forrest Canada, Pfizer, Cubist Pharmaceutical and Theradiag; he has received a research grant from AbbVie Canada; and he has received education grants from AbbVie Canada, Shire Canada, Takeda Canada and Janssen Canada.