Efficacy of Curcumin (turmeric) in the treatment of Inflammatory Bowel Disease: A systematic review

Abstract

Background: Curcumin is an herb that has been demonstrated to have potentanti-inflammatory and anti-neoplastic properties in animal models of IBD. A numberof small studies have reported results in patients with Crohn's or ulcerativecolitis. Objectives: To systematically review the efficacy and safety of curcumin in thetreatment of IBD.SEARCH STRATEGY: A computer-assisted literature search of PUBMED, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the CochraneInflammatory Bowel Disease Specialized Trial Register was performed to identifyrelevant publications followed by a manual search for abstracts and proceedingsfrom major gastrointestinal meetings. References from published articles weresearched to identify additional studies.SELECTION CRITERIA: Clinical trials of curcumin for induction or maintenance ofremission in IBD were included.DATA COLLECTION AND ANALYSIS: Two independent reviewers performed dataextraction and assessment of the methodological quality of the included studies.Data were analysed using Review Manager (Revman 5.1).MAIN Results: Two randomized controlled trials (RCTs) and one open-label studyhave reported efficacy of curcumin in IBD. Due to different populations the datawas not suitable for meta-analysis. A RCT of curcumin to maintain remission in UCshowed a trend towards reduction when compared to those in the placebo group(Relative risk: 0.24; 95% CI: 0.05 to 1.09; P=0.05). However, there was no such reductionat 12 months after initiation of therapy (RR 0.61; 95% CI 0.24 to 1.58; P=0.43).An RCT of curcumin in steroid-dependent patients with IBD reported that curcuminwas not superior to placebo in inducing remission in this patient population. Finallya pilot study of open-label curcumin for active IBD reported 3/5 patients with ulcerativeproctitis had significant improvement in global scores, and 2/4 patients withCrohn's disease had a drop in CDAI > 70 points. There were no serious adverseevents reported with use of curcumin in any study.AUTHORS' ConclusionS: The available evidence is not sufficient to recommendthe use of curcumin in management of patients with IBD. A large scale methodologicallyrigorous randomised controlled trial is needed to prove or disprove theefficacy of this intervention.