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Abstract

Background: Osteoarthritis is an inflammatory joint disease that affects about 43 million people in the world with 80% of the geriatric population. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are usually used as pain relievers to reduce the symptoms of osteoarthritis. However, treatment with NSAIDs is considered to cause certain side effects, so the treatment solution using turmeric extract (Curcuma longa) can be used as a main treatment instead of NSAIDs with minimal side effects. Objective: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of curcuma extract in the treatment of geriatric patients with knee osteoarthritis.


Method: This systematic review and meta-analysis were made with a systematic literature search method from four databases, such as PubMed, ScienceDirect, and ProQuest. Inclusion criteria included experimental Randomized Control Trial (RCT) and discussed related topics. Results were shown as mean difference (MD) and standard deviation (SD). A fixed-effect model (FEM was used when the included studies were considered homogenous), which was indicated by an I2 value of less than 40%. The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2).


Result: This study included five randomized control trial studies with a total of 671 participants. VAS score declined with a significant pooled mean difference (MD) of -1.94 [95% CI : (-2.97) - (-0.92), P = 0.0002] with I2 showing 99%. KOOS index with a significant pooled mean difference (MD) of 2.82 [95% CI: 1.48 - 4.16, P<0.0001] with I2 showing 0%.


Conclusion: Herbal extracts have better efficacy and safety than placebo and are comparable to the use of NSAID drugs through mechanisms such as anti-inflammatory and antioxidant with minimal side effects.

Keywords

curcuma, osteoarthritis, geriatric

Article Details

References

  1. Bortoluzzi A, Furini F, Scirè CA. Osteoarthritis and its management - Epidemiology, nutritional aspects and environmental factors. Autoimmun Rev. 2018 Nov;17(11):1097–104.
  2. Vos T, Allen C, Arora M, Barber R, Bhutta Z, Brown A, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990– 2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016 Oct 8;388:1545–602.
  3. Berenbaum F, Wallace IJ, Lieberman DE, Felson DT. Modern-day environmental factors in the pathogenesis of osteoarthritis. Nat Rev Rheumatol. 2018 Nov;14(11):674– 81.
  4. Badan Penelitian dan Pengembangan Kesehatan Kementerian RI. Riset Kesehatan Dasar (Riskesdas) 2018. Indonesia: Kementerian Kesehatan Republik Indonesia;
  5. Stewart HL, Kawcak CE. The Importance of Subchondral Bone in the Pathophysiology of Osteoarthritis. Front Vet Sci. 2018;5:178.
  6. Wojcieszek A, Kurowska A, Majda A, Liszka H, Gądek A. The Impact of Chronic Pain, Stiffness and Difficulties in Performing Daily Activities on the Quality of Life of Older Patients with Knee Osteoarthritis. Int J Environ Res Public Health. 2022 Dec 14;19(24):16815.
  7. Campbell CM, Buenaver LF, Finan P, Bounds
  8. SC, Redding M, McCauley L, et al. Sleep, Pain Catastrophizing, and Central Sensitization in Knee Osteoarthritis Patients With and Without Insomnia. Arthritis Care Res. 2015 Oct;67(10):1387–96.
  9. Perhimpunan Reumatologi Indonesia. Rekomendasi IRA untuk Diagnosis dan Penatalaksanaan Osteoartritis. Divisi Reumatologi Departemen Ilmu Penyakit Dalam FKUI/RSCM; 2014. (1–3 p).
  10. Bindu S, Mazumder S, Bandyopadhyay U. Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective. Biochem Pharmacol. 2020 Oct;180:114147.
  11. Wongrakpanich S, Wongrakpanich A, Melhado K, Rangaswami J. A Comprehensive Review of Non-Steroidal Anti-Inflammatory Drug Use in The Elderly. Aging Dis. 2018 Feb 1;9(1):143–50.
  12. Mozaffari-Khosravi H, Naderi Z, Dehghan A, Nadjarzadeh A, Fallah Huseini H. Effect of Ginger Supplementation on Proinflammatory Cytokines in Older Patients with Osteoarthritis: Outcomes of a Randomized Controlled Clinical Trial. J Nutr Gerontol Geriatr. 2016;35(3):209–18.
  13. Heidari-Beni M, Moravejolahkami AR, Gorgian P, Askari G, Tarrahi MJ, Bahreini-Esfahani N. Herbal formulation “turmeric extract, black pepper, and ginger” versus Naproxen for chronic knee osteoarthritis: A randomized, double-blind, controlled clinical trial. Phytother Res PTR. 2020 Aug;34(8):2067–73.
  14. Singhal S, Hasan N, Nirmal K, Chawla R, Chawla S, Kalra BS, et al. Bioavailable turmeric extract for knee osteoarthritis: a randomized, non-inferiority trial versus paracetamol. Trials. 2021 Jan 30;22(1):105.
  15. Srivastava S, Saksena AK, Khattri S, Kumar S, Dagur RS. Curcuma longa extract reduces inflammatory and oxidative stress biomarkers in osteoarthritis of knee: a four-month, double-blind, randomized, placebo-controlled trial. Inflammopharmacology. 2016
  16. Dec;24(6):377–88.
  17. Burckhardt C, Dupree Jones K. Adult measures of pain: the McGill Pain Questionnaire (MPQ), Rheumatoid Arthritis Pain Scale (RAPS), Short-Form McGill Pain Questionnaire (SF- MPQ), Verbal Descriptive Scale (VDS), Visual Analog Scale (VAS), and West Haven- Yale Multidisciplinary Pain Inventory (WHYMPI). Arthritis Care Res. 2003 Oct
  18. ;49:S96–104.
  19. Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee Injury and Osteoarthritis Outcome Score (KOOS)--development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998 Aug;28(2):88–96.
  20. Madhu K, Chanda K, Saji MJ. Safety and efficacy of Curcuma longa extract in the treatment of painful knee osteoarthritis: a randomized placebo-controlled trial.
  21. Inflammopharmacology. 2013
  22. Apr;21(2):129–36.
  23. Lopresti AL, Smith SJ, Jackson-Michel S, Fairchild T. An Investigation into the Effects of a Curcumin Extract (Curcugen®) on Osteoarthritis Pain of the Knee: A Randomised, Double-Blind, Placebo- Controlled Study. Nutrients. 2021 Dec 23;14(1):41.
  24. Shep D, Khanwelkar C, Gade P, Karad S. Efficacy and safety of combination of curcuminoid complex and diclofenac versus diclofenac in knee osteoarthritis: A randomized trial. Medicine (Baltimore). 2020
  25. Apr;99(16):e19723.
  26. Henrotin Y, Malaise M, Wittoek R, de Vlam K, Brasseur JP, Luyten FP, et al. Bio-optimized Curcuma longa extract is efficient on knee osteoarthritis pain: a double-blind multicenter randomized placebo controlled three-arm study. Arthritis Res Ther. 2019 Jul 27;21(1):179.
  27. Dobson GP, Letson HL, Grant A, McEwen P, Hazratwala K, Wilkinson M, et al. Defining the osteoarthritis patient: back to the future. Osteoarthritis Cartilage. 2018
  28. Aug;26(8):1003–7.
  29. Loef M, Schoones JW, Kloppenburg M, Ioan- Facsinay A. Fatty acids and osteoarthritis: different types, different effects. Joint Bone Spine. 2019 Jul;86(4):451–8.
  30. Sohn DH, Sokolove J, Sharpe O, Erhart JC, Chandra PE, Lahey LJ, et al. Plasma proteins present in osteoarthritic synovial fluid can stimulate cytokine production via Toll-like receptor 4. Arthritis Res Ther. 2012 Jan 8;14(1):R7.
  31. Karlowicz-Bodalska K, Han S, Freier J, Smolenski M, Bodalska A. CURCUMA LONGA AS MEDICINAL HERB IN THE TREATMENT OF DIABET- IC COMPLICATIONS. Acta Pol Pharm. 2017 Mar;74(2):605–10.
  32. Wang Z, Jones G, Winzenberg T, Cai G, LaslettLL, Aitken D, et al. Effectiveness of Curcuma longa Extract for the Treatment of Symptoms and Effusion-Synovitis of Knee Osteoarthritis : A Randomized Trial.