Date of Award

2018

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not curcuminoids are effective in reducing knee pain in adults with knee osteoarthritis.

STUDY DESIGN: A review of two English language double-blind placebo-controlled randomized controlled trials and one double-blind randomized control trial (RCT) published within peer-reviewed journals after the year 2013. The studies include adult participants age 40 and over.

DATA SOURCES: Double-blind randomized controlled trials were found using PubMed database. These studies compared treatment with curcuminoids with ibuprofen or a placebo.

OUTCOMES MEASURED: Clinical outcomes of pain, stiffness and function were measured using the traditional Western Ontario & McMaster Universities Arthritis Index (WOMAC) and Visual Analog Scale (VAS); 6-minute walk distance to measure function; use of adjunctive nonsteroidal anti-inflammatory drugs (NSAIDs) for pain management. This review will primarily focus on the areas of pain outcome.

RESULTS: One RCT found that curcuminoids provided a significant drop from baseline pain after 4 weeks using the Thai modified WOMAC scale, and showed a better safety profile versus ibuprofen. Two RCTs found that curcuminoids provided a significant decrease in baseline as well as a greater decrease in pain outcomes when compared to that of the placebo control group measured using the traditional WOMAC scale and VAS after 6 and 8 weeks, respectively. It is also worth noting that both of these RCTs also showed significant reduction in patient use of NSAIDs as an adjunctive in pain management when compared to the placebo group.

CONCLUSION: The results of the three randomized controlled trials present evidence that curcuminoids, given short-term, can effectively reduce knee pain in adults with knee osteoarthritis and coincidentally decrease the dependence on NSAIDs as adjunctive pain management. Curcuminoid dosages and dosing schedules, duration of therapy, and safety of treatment need to be more accurately determined through future trials.

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