FRI0726-HPR Study on the efficacy of curcumin therapy in early stages of juvenile oligoarthritis
Authors: C. Ailioaie, L.M. Ailioaie
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> Juvenile arthritis is one of the most common rheumatic diseases in childhood. With all remission drugs, a high percentage of patients continue to have an active disease as young adults and sometimes locomotor and ocular sequelae. Turmeric originated in South Asia is used as spice in these regions and has in its structure a polyphenolic compound called Curcumin, very well known for its anti-microbial, anti-inflammatory, anti-oxidative effects and anti-cancer action. Pleiotropic effects are demonstrated by inhibition of transcriptional-kappa B nuclear factor and subsequently of tumor necrosis factor, IL-12 and IL-2 cytokines involved in the inflammatory cascade. Curcumin has been successfully administered in rheumatoid arthritis, but less investigated in juvenile arthritis. <h3>Objectives:</h3> Aim of study was to evaluate the effects of curcumin administration in patients with Oligoarticular Juvenile Idiopathic Arthritis (OJIA) as an integrated therapy at the onset of the disease. <h3>Methods:</h3> Thirty-two children aged 8–16 years with OJIA were included in a randomized placebo controlled trial from May 2014 – May 2017. All patients were initially hospitalized at the "St. Mary" Emergency Hospital for Children, Iasi and met the criteria of the American College of Rheumatology (ACR). Patients and their parents/legal guardians signed an informative consent on the treatment with curcumin at Laser Clinic. Patients were randomly assigned to one of the two groups: Group 1 (16 patients) received UltraCur 600 mg of Protein Curcumin Complex (15,000-fold bioavailability supplement), 1.8 g per day (in 3 doses, during meals) for 9 months and Group 2 (16 patients) received <i>placebo</i>; all patients were under their standard treatment. Disease activity was evaluated at 0, 3, 6 and 9 months using ACR Pedi30 score. This score defines the improvement of at least 30% from baseline in three of the six variables in the base set, while no more than one of the remaining variables may worsen by&gt;30%. Core set criteria were: physician global assessment of disease activity (0–10 cm VAS); parent/patient global assessment of overall well-being (0–10 cm VAS); functional ability; number of joints with active arthritis; number of joints with limited range of motion; and ESR. <h3>Results:</h3> All patients completed the study. After 3 months from the initiation of Curcumin therapy, patients in group 1 had an improvement of 75% ACR Pedi30, compared to only 37.5% (p=0.0353) in control group. In the end, ACR Pedi30, 50, 70 and 90 scores improved by 87.50%, 81.25%, 68.75% and 43.75%; compared to only 56.25% (p=0.0508), 50% (p=0.0670), 37.5% (p=0.0813) and 12.75% (p=0.0553) in the control group. Curcumin at 1.8 g/day associated with standard therapy was well tolerated, did not induce major reactions and ultimately reduced rheumatic disease activity scores statistically significant (p&lt;0.05) compared to <i>placebo</i>. <h3>Conclusions:</h3> Results proved that curcumin in combination with standard therapy is safe, well tolerated, available at a low cost and has significantly improved the outcome in early stages of OJIA. <h3>References</h3> 1. Ramsewak RS, DeWitt DL, Nair MG. Cytotoxicity, antioxidant and anti-inflammatory activities of curcumins I–III from Curcuma longa. Phytomedicine2000;7:303–308. 2. Xu YX, Pindolia KR, Janakiraman N, Chapman RA, Gautam SC. Curcumin inhibits IL1 alpha and TNF-alpha induction of AP-1 and NF-kB DNA-binding activity in bone marrow stromal cells. Hematopathol Mol Hematol1997;11:49–62. <h3>Disclosure of Interest:</h3> None declared