Published online May 6, 2017. doi: 10.4292/wjgpt.v8.i2.147
Peer-review started: October 19, 2016
First decision: December 27, 2016
Revised: January 5, 2017
Accepted: March 12, 2017
Article in press: March 14, 2017
Published online: May 6, 2017
To evaluate the role of oral curcumin in inducing clinical remission in patients with mild to moderate ulcerative colitis (UC).
A prospective randomized double-blind placebo-controlled trial comparing the remission inducing effect of oral curcumin and mesalamine 2.4 g with placebo and mesalamine 2.4 g in patients of ulcerative colitis with mild to moderate severity was conducted from January 2003 to March 2005. The included patients received 1 capsule thrice a day of placebo or curcumin (150 mg) for 8 wk. Patients were evaluated clinically and endoscopically at 0, 4 and 8 wk. The primary outcome was clinical remission at 8 wk and secondary outcomes were clinical response, mucosal healing and treatment failure at 8 wk. The primary analysis was intention to treat worst case scenario (ITT-WCS).
Of 300 patients with UC, 62 patients (curcumin: 29, placebo: 33) fulfilled the inclusion criteria and were randomized at baseline. Of these, 21 patients did not complete the trial, 41 patients (curcumin: 16, placebo: 25) finally completed 8 wk. There was no significant difference in rates of clinical remission (31.3% vs 27.3%, P = 0.75), clinical response (20.7% vs 36.4%, P = 0.18), mucosal healing (34.5% vs 30.3%, P = 0.72), and treatment failure (25% vs 18.5%, P = 0.59) between curcumin and placebo at 8 wk.
Low dose oral curcumin at a dose of 450 mg/d was ineffective in inducing remission in mild to moderate cases of UC.
Core tip: Not all patients with mild to moderate ulcerative colitis (UC) respond to available treatment options. Curcumin, an active ingredient of turmeric has anti-inflammatory properties and has been shown to play a protective role in chemically induced mouse models of inflammatory bowel disease and to reduce relapse rates in human UC. However, optimum dose ranging studies for curcumin in ulcerative colitis have not been performed. The present study shows that low dose curcumin (450 mg/d) is ineffective in inducing remission in mild to moderate ulcerative colitis. Therefore, higher doses with effective modes of delivery are required for optimal efficacy of curcumin.