PMID 27533649 Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials Meta-analysis · J Med Food, 2016 (note: first author affiliated with a supplement manufacturer) 8 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s - turmericThe spice (Curcuma longa root) that contains curcumin, which makes up about 2-5% of it./curcumin lowered arthritis pain (PVAS -2.04) and WOMACA standard index scoring pain, stiffness, and function in knee or hip osteoarthritis. (-15.36) vs placeboAn inert dummy treatment used as the comparison baseline. and matched analgesics, but trials were few/low-quality with a manufacturer conflict of interest.
Key summary
The first systematic review and meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of turmericThe spice (Curcuma longa root) that contains curcumin, which makes up about 2-5% of it./curcumin for arthritis symptoms. Pooling eight RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s, pain (PVAS) fell versus placeboAn inert dummy treatment used as the comparison baseline. (mean difference -2.04, 3 trials) and WOMACA standard index scoring pain, stiffness, and function in knee or hip osteoarthritis. fell (-15.36, 4 trials), and in five trials pain reduction matched analgesics. The dose was roughly 1000 mg curcumin a day. Included trials had low-to-moderate risk of bias and there was no publication bias. However, the authors stated that the number of trials, sample size, and methodological quality were insufficient for definitive conclusions. The first author's affiliation with a supplement manufacturer (Daily Manufacturing) is a conflict of interest to weigh.
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Although turmeric and its curcumin-enriched extracts have been used for treating arthritis, no systematic review and meta-analysis of randomized clinical trials (RCTs) have been conducted to evaluate the strength of the research. We systemically evaluated all RCTs of turmeric extracts and curcumin for treating arthritis symptoms to elucidate the efficacy of curcuma for alleviating the symptoms of arthritis. A pain visual analogue score (PVAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used for the major outcomes of arthritis. Initial searches yielded 29 articles, of which 8 met specific selection criteria. Three among the included RCTs reported reduction of PVAS (mean difference: -2.04 [-2.85, -1.24]) with turmeric/curcumin in comparison with placebo (P < .00001), whereas meta-analysis of four studies showed a decrease of WOMAC with turmeric/curcumin treatment (mean difference: -15.36 [-26.9, -3.77]; P = .009). Furthermore, there was no significant mean difference in PVAS between turmeric/curcumin and pain medicine in meta-analysis of five studies. Eight RCTs included in the review exhibited low to moderate risk of bias. There was no publication bias in the meta-analysis. In conclusion, these RCTs provide scientific evidence that supports the efficacy of turmeric extract (about 1000 mg/day of curcumin) in the treatment of arthritis. However, the total number of RCTs included in the analysis, the total sample size, and the methodological quality of the primary studies were not sufficient to draw definitive conclusions. Thus, more rigorous and larger studies are needed to confirm the therapeutic efficacy of turmeric for arthritis. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 28236605 Clinical Use of Curcumin in Depression: A Meta-Analysis Meta-analysis · J Am Med Dir Assoc, 2017 6 trials, 377 people - curcumin lowered depression scores vs placeboAn inert dummy treatment used as the comparison baseline. (SMD -0.344, P=0.002) with no adverse events; but only 6 short (4-8 week) trials, so long-term evidence is lacking.
Key summary
The first meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of curcumin's antidepressant effect. Pooling six clinical trials (377 patients) in people with depression, the Hamilton Depression scale fell significantly versus placeboAn inert dummy treatment used as the comparison baseline. (standardized mean difference -0.344, 95% CI -0.558 to -0.129, P=0.002), with anti-anxiety effects reported in three trials. There were no adverse events and most trials had low risk of bias. However, with only six trials a publication-bias test was impossible, and all ran 4 to 8 weeks, leaving long-term effect and safety unknown. The authors concluded that larger, more rigorous RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s with longer follow-up are needed.
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INTRODUCTION: There is growing interest in the use of curcumin, a plant polyphenol with potent anti-inflammatory, anti-oxidant, and neuroprotective properties, as a novel antidepressant. Clinical trials have yielded conflicting conclusions pertaining to its effectiveness in depression. RESULTS: Six clinical trials with a total of 377 patients were reviewed, comparing the use of curcumin to placebo. In patients with depression, the pooled standardized mean difference from baseline Hamilton Rating Scale for Depression scores (pooled standardized mean difference -0.344, 95% confidence interval -0.558 to -0.129; P = .002) support the significant clinical efficacy of curcumin in ameliorating depressive symptoms. Significant anti-anxiety effects were also reported in 3 of the trials. Notably, no adverse events were reported in any of the trials. Most trials had a generally low risk of bias, except for an open trial of curcumin and a single-blinded study. LIMITATIONS: Because of the small number of studies available, a funnel plot or sensitivity analysis was not possible. Evidence on the long-term efficacy and safety of curcumin is also limited as the duration of all available studies ranged from 4 to 8 weeks. CONCLUSIONS: Curcumin appears to be safe, well-tolerated, and efficacious among depressed patients. More robust randomized controlled trials with larger sample sizes and follow-up studies carried out over a longer duration should be planned to ascertain its benefits. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 28074653 The Essential Medicinal Chemistry of Curcumin Critical review · J Med Chem, 2017 Classifies curcumin as PAINSPan-assay interference compounds - substances that give false-positive readouts across many assays without real activity; curcumin is a classic example./IMPS (false activity) - despite 120+ trials, 'no double-blind placeboAn inert dummy treatment used as the comparison baseline.-controlled trial has been successful'; unstable and nonbioavailable.
Key summary
A prominent review directly criticizing the curcumin craze from a medicinal-chemistry standpoint. It notes that curcumin (up to about 5% of turmericThe spice (Curcuma longa root) that contains curcumin, which makes up about 2-5% of it.) has been classified as a compound that reacts across assays without real activity (PAINSPan-assay interference compounds - substances that give false-positive readouts across many assays without real activity; curcumin is a classic example.) and as an invalid metabolic panacea (IMPS) candidate. This apparent activity drove more than 120 clinical trials, yet it asserts that no double-blind, placeboAn inert dummy treatment used as the comparison baseline.-controlled trial of curcumin has been successful. It concludes that curcumin is unstable, reactive, and nonbioavailable, making it a highly improbable drug lead - a prime example of lab and marketing expectations far outrunning actual clinical evidence.
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Curcumin is a constituent (up to ∼5%) of the traditional medicine known as turmeric. Interest in the therapeutic use of turmeric and the relative ease of isolation of curcuminoids has led to their extensive investigation. Curcumin has recently been classified as both a PAINS (pan-assay interference compounds) and an IMPS (invalid metabolic panaceas) candidate. The likely false activity of curcumin in vitro and in vivo has resulted in >120 clinical trials of curcuminoids against several diseases. No double-blinded, placebo controlled clinical trial of curcumin has been successful. This manuscript reviews the essential medicinal chemistry of curcumin and provides evidence that curcumin is an unstable, reactive, nonbioavailable compound and, therefore, a highly improbable lead. On the basis of this in-depth evaluation, potential new directions for research on curcuminoids are discussed. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 17999464 Bioavailability of curcumin: problems and promises Review · Mol Pharm, 2007 Curcumin is safe even at 12 g/day but poorly absorbed and rapidly metabolized/excreted, giving very low blood levels - needs enhancers like piperine, liposomes, nanoparticles.
Key summary
A key review summarizing curcumin's bioavailabilityThe fraction of an ingested substance that actually reaches the blood and tissues to act. problem. Curcumin has diverse reported pharmacologic effects and was safe even at 12 g/day in phase I trials, but poor absorption and rapid metabolism and elimination leave plasma and tissue levels very low. To improve this, several approaches have been tried: piperine (blocking glucuronidation), liposomal curcumin, nanoparticles, phospholipid complexes, and structural analogues. Although efficacy has been reported across various diseases despite low bioavailability, the core message is that, taken plainly, absorption is the bottleneck.
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Curcumin, a polyphenolic compound derived from dietary spice turmeric, possesses diverse pharmacologic effects including anti-inflammatory, antioxidant, antiproliferative and antiangiogenic activities. Phase I clinical trials have shown that curcumin is safe even at high doses (12 g/day) in humans but exhibit poor bioavailability. Major reasons contributing to the low plasma and tissue levels of curcumin appear to be due to poor absorption, rapid metabolism, and rapid systemic elimination. To improve the bioavailability of curcumin, numerous approaches have been undertaken. These approaches involve, first, the use of adjuvant like piperine that interferes with glucuronidation; second, the use of liposomal curcumin; third, curcumin nanoparticles; fourth, the use of curcumin phospholipid complex; and fifth, the use of structural analogues of curcumin (e.g., EF-24). Despite the lower bioavailability, therapeutic efficacy of curcumin against various human diseases, including cancer, cardiovascular diseases, diabetes, arthritis, neurological diseases and Crohn's disease, has been documented. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
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