Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia.
Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Curr Rheumatol Rep. 2021 Jan 28;23(2):11. doi: 10.1007/s11926-020-00975-8.
Finding appropriate pharmacological options to treat osteoarthritis (OA) remain challenging. We aimed to determine the efficacy and safety of all types of turmeric extracts for the management of knee OA.
Sixteen RCTs of up to 16 weeks duration including 1810 adults with knee OA were included. Eleven RCTs compared the efficacy of turmeric extracts with placebo and five with active comparators (NSAIDs). The overall risk bias of included RCTs was moderate. Turmeric extracts significantly reduced knee pain (SMD - 0.82, 95% CI - 1.17 to - 0.47, I = 86.23%) and improved physical function (SMD - 0.75, 95% CI - 1.18 to - 0.33, I = 90.05%) compared to placebo but had similar effects compared to NSAIDs. BMI was the major contributor to heterogeneity in the placebo-controlled studies (explained 37.68% and 67.24%, respectively, in the models) and modified the effects of the turmeric on pain and physical function with less improvement with higher BMI (SMD 0.26 95% CI 0.04 to 0.48; SMD 0.48 95% CI 0.21 to 0.74). No significant between-group differences were reported for either biochemical markers or imaging outcomes. Turmeric extracts had 12% fewer adverse events than NSAIDs and similar rates to placebo. Turmeric extract is a safe and effective option for the symptomatic management of knee OA, compared to placebo or NSAIDs. However, current evidence from short-term studies is heterogeneous and has moderate risk of bias leading to some uncertainty about the true effect.
寻找治疗骨关节炎(OA)的合适药物仍然具有挑战性。本研究旨在确定各种姜黄提取物治疗膝骨关节炎的疗效和安全性。
纳入了 16 项为期长达 16 周的 RCT,共纳入了 1810 例膝骨关节炎患者。11 项 RCT 比较了姜黄提取物与安慰剂的疗效,5 项与活性对照物(非甾体抗炎药)比较。纳入 RCT 的整体风险偏倚为中度。与安慰剂相比,姜黄提取物可显著减轻膝关节疼痛(SMD -0.82,95%CI-1.17 至-0.47,I=86.23%)和改善躯体功能(SMD -0.75,95%CI-1.18 至-0.33,I=90.05%),但与 NSAIDs 的效果相当。BMI 是安慰剂对照研究中异质性的主要影响因素(模型中分别解释了 37.68%和 67.24%),并改变了姜黄对疼痛和躯体功能的影响,BMI 越高,改善越小(SMD 0.26,95%CI 0.04 至 0.48;SMD 0.48,95%CI 0.21 至 0.74)。两组间在生化标志物或影像学结果方面均无显著差异。与 NSAIDs 相比,姜黄提取物不良反应发生率低 12%,与安慰剂相似。与安慰剂或 NSAIDs 相比,姜黄提取物是治疗膝骨关节炎症状的安全有效选择。然而,目前短期研究的证据存在异质性,且存在中度偏倚风险,这导致对真实疗效存在一定的不确定性。