A RANDOMIZED CONTROLLED TRIAL OF CURCUMIN AND DICLOFENAC COMBINATION IN KNEE OSTEOARTHRITIS

DHANESHWAR SHEP; CHITRA KHANWELKAR; PRAKASHCHANDRA GADE; SATYANAND KARAD

doi:10.22159/ijcpr.2019v11i6.36355

Authors

DHANESHWAR SHEP Department of Pharmacology, Krishna Institute of Medical Sciences, Satara, Maharashtra, India
CHITRA KHANWELKAR Department of Pharmacology, Krishna Institute of Medical Sciences, Satara, Maharashtra, India
PRAKASHCHANDRA GADE Department of Pharmacology, Dr. Vithalrao Vikhe Patil Foundation's Medical College and Hospital, Ahmednagar, Maharashtra, India
SATYANAND KARAD Department of Orthopedics, City Care Accident Hospital, Parli Vaijnath, Beed, Maharashtra, India

DOI:

https://doi.org/10.22159/ijcpr.2019v11i6.36355

Keywords:

Knee osteoarthritis, Curcumin, Diclofenac, Pain

Abstract

Objective: The objective of the study was to evaluate pain relief and safety of the combination of curcumin and diclofenac versus diclofenac alone in the treatment of knee osteoarthritis (OA).

Methods: 140 patients of knee OA meeting inclusion criteria were randomized to receive either curcumin 500 mg with diclofenac 50 mg twice daily or diclofenac 50 mg tablet alone twice daily for 28 d. Patients were assessed at baseline, Day 14 and Day 28. Primary efficacy measure was severity of pain (Visual Analogue Scale) at day 14 and day 28. Safety after treatment was evaluated by recording side effects and laboratory investigations.

Results: Patients receiving curcumin plus diclofenac showed significantly superior improvement in severity of pain at each study visit (p<0.001) when compared to diclofenac. Adverse effects were significantly less in curcumin plus diclofenac group (p<0.001).

Conclusion: Combination of curcumin and diclofenac showed a significant improvement in pain on the basis of VAS when compared to diclofenac which may be due to synergistic effect between curcumin and diclofenac

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References

1. Buys LM, Elliott M. Osteoarthritis. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey L. eds. Pharmacotherapy: a pathophysiologic approach. 9th ed. New York, NY: McGraw-Hill; 2014. p. 1437-58.
2. Altman R, Asch E, Bloch G. Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthritis Rheum 1986;29:1039-49.
3. Hochberg MC, Altman RD, April KT. American college of rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res 2012;64:465-74.
4. Bannuru RR, Schmid CH, Kent DM, Vaysbrot EE, Wong JB, Mcalindon TE. Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and network meta-analysis. Ann Int Med 2015;162:46–54.
5. Nelson AE, Allen KD, Golightly YM, Goode AP, Jordan JM. A systematic review of recommendations and guidelines for the management of osteoarthritis: the chronic osteoarthritis management initiative of the U. S. bone and joint initiative. Semin Arthritis Rheum 2014;43:701–12.
6. Da Costa BR, Hari R, Juni P. Intra-articular corticosteroids for osteoarthritis of the knee. JAMA 2016;316:2671-2.
7. Sharma V, Anuvat K, John L, Davis M. Scientific american pain management-arthritis of the knee. Decker: Pain related disease states; 2017.
8. Richebe P, Capdevila X, Rivat C. Persistent postsurgical pain: pathophysiology and preventative pharmacologic considerations. Anesthesiology 2018;129:590-607.
9. Hadler NM. Knee pain is the malady-not osteoarthritis. Ann Intern Med 1992;116:598–9.
10. Ayis S, Dieppe P. The natural history of disability and its determinants in adults with lower limb musculoskeletal pain. J Rheumatol 2009;36:583–91.
11. Dominick KL, Ahern FM, Gold CH, Heller DA. Health-related quality of life and health service use among older adults with osteoarthritis. Arthritis Rheum 2004;51:326–31.
12. McAlindon TE, Cooper C, Kirwan JR, Dieppe PA. Determinants of disability in osteoarthritis of the knee. Ann Rheum Dis 1993;52:258–62.
13. Prasad S, Tyagi AK, Aggarwal BB. Recent developments in delivery, bioavailability, absorption and metabolism of curcumin: the golden pigment from golden spice. Cancer Res Treat 2014;46:2-18.
14. Dhaneshwar Shep, Chitra Khanwelkar, Prakashchandra Gade, Satyanand Karad. Safety and efficacy of curcumin versus diclofenac in knee osteoarthritis: a randomized open-label parallel-arm study. Trials 2019;20:214.
15. Henrotin Y, Priem F, Mobasheri Ali. Curcumin: a new paradigm and therapeutic opportunity for the treatment of osteoarthritis: curcumin for osteoarthritis management. Springerplus 2013;2:56.
16. Aggarwal B, Kumar A, Bharti A. Anticancer potential of curcumin: preclinical and clinical studies. Anticancer Res 2003;23(1A):363–98.
17. Sharma R, Gescher A, Steward W. Curcumin: the story so far. Eur J Cancer 2005;41:1955–68.
18. Shishodia S, Sethi G, Aggarwal B. Curcumin: getting back to the roots. Ann NY Acad Sci 2005;1056:206–17.