The efficacy of high- and low-dose curcumin in knee osteoarthritis: A systematic review and meta-analysis

An-Fang Hsiao, Yi-Chieh Lien, I-Shiang Tzeng, Chien-Ting Liu, Sheng-Hsun Chou, Yi-Shiung Horng · Complementary Therapies in Medicine · 2021 December

DOI 10.1016/j.ctim.2021.102775

Objective

The aim of this study was to critically appraise and evaluate effects of low- and high-dose curcuminoids on pain and functional improvement in patients with knee osteoarthritis (OA) and to compare adverse events (AEs) between curcuminoids and non-steroid anti-inflammatory drugs (NSAIDs).

Conclusions

The results of our meta-analysis suggest that curcuminoids are effective in pain relief in knee osteoarthritis (OA) and that low- and high-dose curcuminoids have similar effects in improving pain and adverse events (AEs). Curcuminoids are also more effective in achieving pain relief than non-steroid anti-inflammatory drugs (NSAIDs); therefore, using curcuminoids as an adjunctive treatment in knee osteoarthritis (OA) is recommended.

Critical Appraisal

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Insights

Turmeric curcuminoids are associated with better pain relief than NSAIDs in knee osteoarthritis.

The meta-analysis results showed that curcuminoids were significantly more effective than comparators regarding visual analogue scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain scores. However, no significant difference in pain relief or AEs between the high-dose (daily dose ≥1000 mg or total dose ≥42 gm) and low-dose (daily dose <1000 mg or total dose <42 gm) curcuminoid treatments was observed. When comparing curcumininoids versus NSAIDs, a significant difference in VAS pain was found. For AE analysis, three of our included studies used NSAIDs as comparators, with all reporting higher AE rates in the NSAID group, though significance was reached in only one study.