Researchers randomly assigned patients with symptomatic knee osteoarthritis to take two capsules of turmeric capsules (n=36) or placebo (n=34) daily for 12 weeks. At the end of the study period, turmeric improved knee pain on a visual analog scale (VAS) by -9.1 mm (95% CI, -17.8 to -0.4 mm) compared with placebo, but did not alter effusion-synovitis volume on magnetic resonance imaging.
In addition, turmeric improved knee pain measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) by -47.2 mm (CI, -81.2 to -13.2 mm) compared with placebo, but didn't impact lateral femoral cartilage.
"The moderate effect we found in our trial from a short-term study is reassuring for turmeric as a treatment option," said senior study author Dr Benny Eathakkttu Antony of the Menzies Institute for Medical Research at the University of Tasmania in Hobart, Australia.
"However, there are no long-term studies that explored the efficacy and safety of turmeric extracts for the treatment of osteoarthritis," Antony said by email.
There are no disease-modifying drugs approved to treat knee osteoarthritis, Antony and colleagues note in the Annals of Internal Medicine. Other pain relievers including acetaminophen and nonsteroidal anti-inflammatory drugs have only mild to moderate effects and are associated with adverse events, the researchers point out.
People randomized to take turmeric reported less usage of painkillers like acetaminophen and NSAIDs than those randomized to placebo.
There were no adverse events associated with turmeric in the current study.
"Turmeric extracts are generally considered as safe in moderate doses usually seen in the over-the-counter medication," Antony said. "Curcumin, the most active constituent of turmeric, is generally classified 'generally recognized as safe' by the U.S. FDA as a food supplement."
One limitation of the study is the small sample size and the relatively small effect size of the improvements in pain with turmeric, said Romy Lauche, deputy director of research at the National Centre for Naturopathic Medicine at Southern Cross University in East Lismore, NSW, Australia.
Multicenter trials with larger sample sizes and long duration of follow-up are needed to assess the clinical significance of the findings, Lauche, who wasn't involved in the study, said by email.
Supplements and herbal products are one of many options that some patients may prefer over pharmacological therapies, and to some extent the treatment choice for knee osteoarthritis may come down to individual patient preferences, Lauche said.
Lifestyle management is already recommended as first-line treatment for knee osteoarthritis, with approaches such as physical activity, weight loss, diet, and stress management, Lauche noted.
"Supplements as well as pain medication may be able to support individuals with their osteoarthritis, for example by reducing their pain and helping them to be physically active again," Lauche said. "However, which supplement or medication works is very individual, and patients may need to test different approaches to find the best management strategy before considering invasive treatments such as joint replacement surgery."
By Lisa Rapaport
SOURCE: https://bit.ly/2H1r0hR Annals of Internal Medicine, online September 14, 2020.
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