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Meta-Analysis
. 2018 Nov 12;10(11):1737.
doi: 10.3390/nu10111737.

Oral Adjuvant Curcumin Therapy for Attaining Clinical Remission in Ulcerative Colitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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Free PMC article
Meta-Analysis

Oral Adjuvant Curcumin Therapy for Attaining Clinical Remission in Ulcerative Colitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Maria G Grammatikopoulou et al. Nutrients. .
Free PMC article

Abstract

Curcumin has demonstrated anti-inflammatory properties and has been investigated as an adjuvant therapy of ulcerative colitis (UC). The scope of this study was to systematically review and meta-analyze the efficacy of oral curcumin administration as an adjuvant therapy of UC. MEDLINE, Cochrane/CENTRAL, ClinicalTrials.gov, WHO-ICT Registry, EMBASE and grey literature were searched for relevant randomized controlled trials (RCTs). The primary outcome was clinical remission (attainment) and the secondary outcome was clinical response (maintenance/failure). Risk of bias was assessed with the Cochrane tool. Odds ratios (OR) were calculated with a Mantel-Haenszel (M-H) random effects model and with a beta-binomial (B-B) random effects model when zero events/cells occurred. Four RCTs met the criteria, but one was removed from the analyses due to inconsistency in protocol details. With the M-H method, treatment with curcumin was significantly superior to placebo in attaining remission in the per-protocol (PP) analysis (OR = 5.83, 95%CI = 1.24⁻27.43), but not in the intention-to-treat (ITT) analysis (OR = 4.33, 95%CI = 0.78⁻24.00). However, with the more accurate B-B method, both analyses were insignificant (for PP OR = 4.26, 95%CI = 0.59⁻31.00, for ITT OR = 3.80, 95%CI = 0.55⁻26.28). Based on the current available evidence, oral curcumin administration does not seem superior to placebo in attaining remission in patients with UC. Future RCTs should be planned more cautiously with sufficient size and adhere to the ITT analysis in all outcomes.

Keywords: IBD; RCT; autoimmune diet; autoimmune disease; beta binomial; curcumin; diet; gastrointestinal disease; inflammatory bowel disease; meta-analysis; nutraceutical; proctitis; proctocolitis; rare events; turmeric; ulcerative colitis.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart of the selection process.
Figure 2
Figure 2
Risk of bias summary, stressing authors’ judgments about each risk of bias item for the included RCTs.
Figure 3
Figure 3
Forest plots for the attainment of remission among ulcerative colitis patients receiving curcumin vs. placebo as an adjuvant according to the intention-to-treat (a), and per protocol analyses (b). CI: confidence intervals; M-H: Mantel–Haenszel; Random: Random effects model.

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References

    1. Ng S.C., Shi H.Y., Hamidi N., Underwood F.E., Tang W., Benchimol E.I., Panaccione R., Ghosh S., Wu J.C.Y., Chan F.K.L., et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: A systematic review of population-based studies. Lancet. 2018;390:2769–2778. doi: 10.1016/S0140-6736(17)32448-0. - DOI - PubMed
    1. Weimers P., Munkholm P. The Natural History of IBD: Lessons Learned. Curr. Treat. Opt. Gastroenterol. 2018;16:101–111. doi: 10.1007/s11938-018-0173-3. - DOI - PubMed
    1. Durchschein F., Petritsch W., Hammer H.F. Diet therapy for inflammatory bowel diseases: The established and the new. World J. Gastroenterol. 2016;22:2179–2194. doi: 10.3748/wjg.v22.i7.2179. - DOI - PMC - PubMed
    1. Forbes A., Escher J., Hébuterne X., Kłęk S., Krznaric Z., Schneider S., Shamir R., Stardelova K., Wierdsma N., Wiskin A.E., et al. ESPEN guideline: Clinical nutrition in inflammatory bowel disease. Clin. Nutr. 2017;36:321–347. doi: 10.1016/j.clnu.2016.12.027. - DOI - PubMed
    1. Limketkai B.N., Wolf A., Parian A.M. Nutritional Interventions in the Patient with Inflammatory Bowel Disease. Gastroenterol. Clin. N. Am. 2018;47:155–177. doi: 10.1016/j.gtc.2017.09.007. - DOI - PubMed
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