FRI0728-HPR Cost-reducing and improving quality of life in juvenile arthritis by blue laser and ultrabioavailable curcumin
Authors: L.M. Ailioaie, C. Ailioaie
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> Juvenile idiopathic arthritis (JIA) is associated with significant disease- and treatment-related morbidity, despite all modern management efforts. Photo biomodulation counts today more than 5,000 peer-reviewed published papers, including randomized controlled clinical trials. A review of the literature shows that Curcumin has the potential to be a safe, effective and an affordable alternative in the treatment of chronic inflammation. Its anti-inflammatory mechanism is a molecular response to the down-regulation of enzymatic activity of COX-2, lipoxygenase, and inducible nitric oxide synthase. Photobiomodulation at the maximum absorption spectra of curcumin is an innovative approach due to its complex imuno-modulatory effect. <h3>Objectives:</h3> Aim was to investigate the effects of sublingual photo biostimulation with blue laser in association with ultrabioavailable curcumin in extensive oligoarticular and polyarticular forms of JIA. <h3>Methods:</h3> 48 children with an average age of 13.8 years, diagnosed with JIA were included in a randomized placebo controlled trial from January 2014 to December 2017. Patients together with the legal owners signed an informed consent. Group 1 (28 patients) was administrated along with the standard treatment, Ultra Bioavailable Curcumin (15,000-fold bioavailability) 1200 mg/day p. o. and after 30 minutes was applied sublingual blue laser (447 nm), 5 mW maximum output power continuously, 10 minutes each session. Patients received one session every two days, 5 sessions per month, repeated monthly, for 6 months. Group 2 (20 patients) as control, received only conventional therapy and <i>placebo</i>. Disease activity was evaluated at 0, 4, 12 and 24 weeks with JADAS-71 scores, including: physician's global assessment and parent's global assessment of well-being, both measured on 0–10-cm VAS, normalized ESR (0–10) and active joint count. Childhood Health Assessment Questionnaire (CHAQ) – Disability Index was calculated as a mean of the eight functional areas, on a 4 point scale of difficulty, scored from 0–3 each. Pain level was quantified on 0–10-cm VAS (0-no pain, 10-severe pain). <h3>Results:</h3> In the end of study, median JADAS-71 significantly improved (p=0.0228) in Group I (from 13.8 to 2.8), comparatively with Group II, where the evolution was less favourable (from 14.2 to 7.4). Pain level initially estimated at 7.5 significantly decreased to 2.5 in Group I (66.7%), comparatively to the evolution from 7.4 to 5.2 in <i>placebo</i> group (29.7%)[p=0.0125]. Daily functional activity assessed by the CHAQ score improved with 62.7% in Group I, comparatively with only 13.93% in Group II (p=0.0003). In the end of study the most important economic aspect was that the percentage of patients receiving remissive medications and the corresponding costs per patient have decreased for methylprednisolone by 72.25% in Group 1, comparatively with only 35.04% in <i>placebo</i> group (p=0.0111); methotrexate decreased by 66.7% in Group I, comparatively to only 31.25% for placebo group (p=0.0165). <h3>Conclusions:</h3> Blue laser and curcumin proved to be a safe, efficient and money saver integrative therapeutic intervention with direct impact on JIA patient's quality of life. <h3>Reference</h3> 1. Trubilla KM, Adams L, Francio VT, Brown T. Exploring the Molecular World of Turmeric: An Alternative in the Treatment of Chronic Inflammation. MOJ Cell Sci Rep2017;4(1):00077. doi:10.15406/mojcsr.2017.04.00077 <h3>Disclosure of Interest:</h3> None declared