Turmeric for Knee Osteoarthritis

In osteoarthritis (OA), chronic wear and tear leads to degeneration of articular cartilage and underlying bone. This condition usually affects elderly individuals, but can be accelerated by joint pathologies and abnormal biomechanics, including an elevated body-mass index on joints.

Over half of the people with symptomatic knee OA have advanced OA: approximately 14 million people worldwide. More than 3 million African Americans, Hispanics, and others are among these individuals. The number of adults younger than 45 years old and those between 45 and 65 years old who have symptomatic knee OA constitute nearly 2 million cases.

OA of the knee should be prevented and treated innovatively, especially among young people, based on these data.¹ OA should be managed non-pharmacologically first, and then pharmacologically or surgically only if necessary.

An analysis of over 26,000 participants from 72 randomized, controlled trials was conducted in 2020 by Osani, et al. From four weeks on, NSAIDs were significantly more likely than placebo to cause gastrointestinal (GI) adverse events (relative risk: 1.38).³

Last, but not least, in 2021, Da Costa, et al., performed a meta-analysis involving 192 trials and more than 100,000 participants. Dropout rates due to adverse events were 18.5% and 83.3% for oral NSAIDs and opioids, respectively. There was an increased risk of adverse events associated with 29.8% of oral NSAIDs and 89.5% of opioids, respectively. When oxymorphone was taken at 80 mg/day, adverse events were responsible for the highest dropout rates (51%).⁴

With that said, let’s evaluate turmeric as a possible alternative to oral NSAIDS for the treatment of knee osteoarthritis.

References

1. Deshpande BR, Katz JN, Solomon DH, et al. Number of persons with symptomatic knee osteoarthritis in the us: impact of race and ethnicity, age, sex, and obesity. Arthritis Care Res, 2016;68(12):1743-1750.
2. Lee C, Straus WL, Balshaw R, et al. A comparison of the efficacy and safety of nonsteroidal anti-inflammatory agents versus acetaminophen in the treatment of osteoarthritis: a meta-analysis. Arthritis Rheum, 2004;51(5):746-754
3. Osani MC, Vaysbrot EE, Zhou M, et al. Duration of symptom relief and early trajectory of adverse events for oral nonsteroidal anti-inflammatory drugs in knee osteoarthritis: a systematic review and meta-analysis. Arthritis Care Res, 2020;72(5):641-651.
4. da Costa BR, Pereira TV, Saadat P, et al. Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis. BMJ, 2021;375:n2321.
5. Daily JW, Yang M, Park S. Efficacy of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: a systematic review and meta-analysis of randomized clinical trials. J Med Food, 2016;19(8):717-729.
6. Onakpoya IJ, Spencer EA, Perera R, Heneghan CJ. Effectiveness of curcuminoids in the treatment of knee osteoarthritis: a systematic review and meta-analysis of randomized clinical trials. Int J Rheum Dis, 2017;20(4):420-433.
7. Dai W, Yan W, Leng X, et al. Effectiveness of Curcuma longa extract versus placebo for the treatment of knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Phytother Res, 2021;35(11):5921-5935.
8. Bannuru RR, Osani MC, Al-Eid F, Wang C. Efficacy of curcumin and Boswellia for knee osteoarthritis: systematic review and meta-analysis. Semin Arthritis Rheum, 2018;48(3):416-429.
9. Hsiao AF, Lien YC, Tzeng IS, et al. The efficacy of high- and low-dose curcumin in knee osteoarthritis: a systematic review and meta-analysis. Complement Ther Med, 2021;63:102775
10. Paultre K, Cade W, Hernandez D, et al. Therapeutic effects of turmeric or curcumin extract on pain and function for individuals with knee osteoarthritis: a systematic review. BMJ Open Sport Exerc Med, 2021;7(1):e000935.
11. Wang Z, Singh A, Jones G, et al. Efficacy and safety of turmeric extracts for the treatment of knee osteoarthritis: a systematic review and meta-analysis of randomised controlled trials. Curr Rheumatol Rep, 2021;23(2):11.
12. Feng J, Li Z, Tian L, et al. Efficacy and safety of curcuminoids alone in alleviating pain and dysfunction for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. BMC Complement Med Ther, 2022;22(1):276.
13. Panahi Y, Rahimnia AR, Sharafi M, et al. Curcuminoid treatment for knee osteoarthritis: a randomized double-blind placebo-controlled trial. Phytother Res, 2014;28(11):1625-1631.