Curcumin in Combination With Mesalamine Induces Remission in Patients With Mild-to-Moderate Ulcerative Colitis in a Randomized Controlled Trial.
OBJECTIVE
The phytochemical compound curcumin was reported to be effective in maintaining remission in patients with ulcerative colitis (UC). We investigated curcumin's efficacy in inducing remission in patients with active mild-to-moderate UC.


METHODS
We performed a multicenter randomized, placebo-controlled, double-blind study of 50 mesalamine-treated patients with active mild-to-moderate UC (defined by the Simple Clinical Colitis Activity Index [SCCAI]) who did not respond to an additional 2 weeks of the maximum dose of mesalamine oral and topical therapy. Patients were randomly assigned to groups who were given curcumin capsules (3 g/day, n = 26) or an identical placebo (n = 24) for 1 month, with continued mesalamine. The primary outcome was the rate of clinical remission (SCCAI ≤2) at week 4. Clinical and endoscopic responses were also recorded.


RESULTS
In the intention-to-treat analysis, 14 patients (53.8%) receiving curcumin achieved clinical remission at week 4, compared with none of the patients receiving placebo (P = .01; odds ratio [OR], 42; 95% confidence interval [CI], 2.3-760). Clinical response (reduction of ≥3 points in SCCAI) was achieved by 17 patients (65.3%) in the curcumin group vs. 3 patients (12.5%) in the placebo group (P < .001; OR, 13.2; 95% CI, 3.1-56.6). Endoscopic remission (partial Mayo score ≤1) was observed in 8 of the 22 patients evaluated in the curcumin group (38%), compared with none of 16 patients evaluated in the placebo group (P = .043; OR, 20.7; 95% CI, 1.1-393). Adverse events were rare and comparable between the 2 groups.


CONCLUSIONS
Addition of curcumin to mesalamine therapy was superior to the combination of placebo and mesalamine in inducing clinical and endoscopic remission in patients with mild-to-moderate active UC, producing no apparent adverse effects. Curcumin may be a safe and promising agent for treatment of UC. Clinicaltrials.gov number: NCT01320436.
Gastroenterology Department, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
Alon
A
Lang
Gastroenterology Department, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel; Complementary Medicine Service, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel. Electronic address: nironsl@gmail.com.
Nir
N
Salomon
Institute of Digestive Disease and Hong Kong Institute of Integrative Medicine, Chinese University of Hong Kong, Hong Kong.
Justin C Y
JC
Wu
Gastroenterology Department, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
Uri
U
Kopylov
Gastroenterology Department, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
Adi
A
Lahat
Gastroenterology Department, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
Ofir
O
Har-Noy
Institute of Digestive Disease and Hong Kong Institute of Integrative Medicine, Chinese University of Hong Kong, Hong Kong.
Jessica Y L
JY
Ching
Institute of Digestive Disease and Hong Kong Institute of Integrative Medicine, Chinese University of Hong Kong, Hong Kong.
Pui Kuan
PK
Cheong
Gastroenterology Department, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
Benjamin
B
Avidan
Complementary Medicine Service, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
Dorit
D
Gamus
Central IBD Clinic, Nicosia, Cyprus.
Ioannis
I
Kaimakliotis
Gastroenterology Department, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
Rami
R
Eliakim
Institute of Digestive Disease and Hong Kong Institute of Integrative Medicine, Chinese University of Hong Kong, Hong Kong.
Siew C
SC
Ng
Gastroenterology Department, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
Shomron
S
Ben-Horin
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003474:Curcumin / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000379:methods; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage*; D008875:Middle Aged; D010919:Placebos / Q000008:administration & dosage; D016896:Treatment Outcome; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal; D010919:Placebos; D019804:Mesalamine; D003474:Curcumin
Clinical Trial; IBD; Inflammatory Bowel Disease; Phytochemical