Ulcerative colitis is a chronic intestinal inflammation that flares up again and again. Although conventional drugs such as mesalazine or sulphasalazine can prevent relapses, they are often associated with side effects. Researchers are therefore looking for safe additional therapies.
In this study, Japanese doctors examined curcuminthe yellow active ingredient from turmeric, as a supplement to conventional medication. 89 patients with ulcerative colitis in a resting phase (“remission”) took either curcumin (2 g daily) plus standard medication or a placebo plus standard medication for 6 months.
Result: Only 2 out of 43 patients (4.7%) in the curcumin group suffered a relapse, compared to 8 out of 39 patients (20.5%) in the placebo group. In addition, the clinical and endoscopic findings improved significantly with curcumin. Tolerance was good, with only a few mild side effects such as flatulence or nausea.
Conclusion: Curcumin can help prevent relapses in ulcerative colitis – safely and well tolerated. It is therefore a promising addition to standard therapy. Further larger studies are needed to clarify the optimal dose and long-term effect.
Background
Ulcerative colitis (UC) is a chronic inflammatory bowel disease with a high risk of recurrent flare-ups. Standard medications such as sulfasalazine (SZ) and mesalazine are effective, but are associated with side effects. Curcumin, a polyphenol from Curcuma longa, has anti-inflammatory, antioxidant and NF-κB inhibitory properties. The aim of this study was to investigate the efficacy of curcumin as an adjunct therapy for remission maintenance in CU.
Methods
Between 2004 and 2005, 89 patients with CU in remission were enrolled at 8 Japanese centers. Patients were randomized to receive either:
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Curcumin 2 g/day (1 g in the morning, 1 g in the evening) + SC or mesalazine (n = 45)
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Placebo + SC or mesalazine (n = 44)
The study duration was 6 months, followed by a 6-month follow-up under standard medication alone. The primary endpoints were relapse rate (CAI ≥5), changes in the clinical activity index (CAI) and the endoscopic index (EI).
RESULTS
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Relapses: 2/43 (4.65%) in the curcumin group vs. 8/39 (20.51%) in the placebo group(p = 0.040).
Per-protocol analysis (n = 82):
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Relapses: 4.44 % (curcumin) vs. 15.15 % (placebo), p = 0.049.
Intention-to-treat analysis:
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CAI: improvement in the curcumin group (from 1.3 to 1.0; p = 0.038), deterioration in the placebo group (from 1.0 to 2.2; p = 0.0003).
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EI: significant improvement with curcumin (1.3 to 0.8; p = 0.0001), no change with placebo .
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Follow-up (6 months): No significant difference between the groups.
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Safety: 7 of 89 patients reported mild, transient side effects (e.g. flatulence, nausea, mild increase in blood pressure). No discontinuation due to severe side effects .
Discussion
The results show that curcumin as an additive to SC/mesalazine significantly reduces the relapse rate and improves both clinical and endoscopic findings. The substance was well tolerated and caused no serious side effects. Curcumin thus represents a safe, natural supplement to standard drug therapy.
Limitations: Relatively small number of patients, fixed dosage (2 g/day), no dose finding, lack of monotherapy arms. The optimal dose and the long-term effect should be investigated in larger studies.
Conclusion
Curcumin is a promising candidate for maintaining remission in ulcerative colitis. Its anti-inflammatory properties and favorable safety profile make it an attractive addition to conventional therapies. Further randomized studies are needed to confirm these results and establish its clinical use.