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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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Faculty of Medicine, School of Health Sciences, University of Thessaly, Mezourlo, GR41110 Larissa, Greece
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Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Sindos, P.O. Box 141, GR57400 Thessaloniki, Greece
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Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, GR54124 Thessaloniki, Greece
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Laboratory of Clinical Pharmacology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, GR54124 Thessaloniki, Greece
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Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR41110 Larissa, Greece
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Norwich Medical School, University of East Anglia, Bob Champion Building, James Watson Road, Norwich NR4 7UQ, UK
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Division of Transplantation Immunology and Mucosal Biology, MRC Centre for Transplantation, King’s College London Medical School, London SE5 9RS, UK
*
Author to whom correspondence should be addressed.
Nutrients 2018, 10(11), 1737; https://doi.org/10.3390/nu10111737
Received: 5 September 2018 / Revised: 7 November 2018 / Accepted: 9 November 2018 / Published: 12 November 2018
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. View Full-Text
Keywords: inflammatory bowel disease; diet; turmeric; proctocolitis; proctitis; ulcerative colitis; diet; curcumin; meta-analysis; RCT; autoimmune disease; gastrointestinal disease; autoimmune diet; rare events; nutraceutical; IBD; beta binomial inflammatory bowel disease; diet; turmeric; proctocolitis; proctitis; ulcerative colitis; diet; curcumin; meta-analysis; RCT; autoimmune disease; gastrointestinal disease; autoimmune diet; rare events; nutraceutical; IBD; beta binomial
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Grammatikopoulou, M.G.; Gkiouras, K.; Theodoridis, X.; Asteriou, E.; Forbes, A.; Bogdanos, D.P. Oral Adjuvant Curcumin Therapy for Attaining Clinical Remission in Ulcerative Colitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2018, 10, 1737.

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