Oral Presentation 29th Australian and New Zealand Bone and Mineral Society Annual Scientific Meeting 2019

A randomised clinical trial of Curcuma longa extract for treating symptoms and effusion-synovitis of knee osteoarthritis (#67)

Benny Antony 1 , Zhiqiang Wang 1 , Tania Winzenberg 1 , Guoqi Cai 1 , Laura Laslett 1 , Dawn Aitken 1 , Ingrid Hopper 2 , Robert Jones 3 , Jurgen Fripp 4 , Graeme Jones 1
  1. Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
  2. Department of Epidemiology, Monash University, Melbourne, Victoria, Australia
  3. Department of Radiology, Royal Hobart Hospital, Hobart, TAS, Australia
  4. Biomedical Informatics Group, CSIRO Health and Biosecurity, The University of Queensland, Brisbane, Queensland, Australia

Aims: The CurKOA trial aimed to compare the efficacy of Curcuma longa extract versus placebo for treating knee pain and effusion-synovitis in knee osteoarthritis (OA).

Methods: In this double-blind trial, we randomised 70 participants with significant knee pain (>40 mm knee pain on VAS scale), knee OA (ACR clinical criteria) and presence of a moderate amount of ultrasound-defined effusion/synovitis (>4 mm thickness in the suprapatellar region) on ultrasound to receive Curcuma longa extract (80% Turmerosaccharides+20% Curcuminoids extract, 2x500 mg capsules/day) (n=36) or identical placebo (n=34) for 12 weeks. The primary outcome measures were change in knee pain (assessed by VAS) and MRI-defined effusion-synovitis volume over 12 weeks.

Results: Of the 112 participants screened, a total of 70 participants (age 61.8±8.6 years, 56% female) were randomised, and 97% completed the 12-week assessments.

There was a reduction in VAS knee pain in the treatment (-23.75[-29.78,-17.73]) and placebo (-14.64[-20.80,-8.47]) group, with a significant between-group difference of -9.11mm[-17.79,-0.44] (Figure1a) equivalent to a standard effect size of 0.49. There was a no significant between-group difference (1.25 mL[-1.21,3.72]) in the MRI assessed effusion-synovitis volume.

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Significant changes favouring the treatment group were seen in WOMAC knee pain (between-group difference: -47.22[-81.22,-13.22]) (Figure1b), WOMAC function (-112.26[-222.79,-1.74]) and OARSI-OMERACT treatment responders (63% in the treatment and 38% in the placebo [Risk Ratio=1.64(1.00,2.70)]. No significant change in T2 relaxation time of the femoral cartilage (-0.38 ms[-1.10,0.34]) was seen. The number of adverse events was similar in the treatment (n=18) and placebo (n=29) groups, and there were no adverse events related to the treatment.

Conclusion: Curcuma longa extract significantly improved knee pain in knee OA patients with effusion over 12 weeks compared to placebo. There was a moderate standard effect size of the treatment. In this short term study, Curcuma longa extract had no effect on knee structural measures assessed using MRI.