Nachum Nurit Loberman, Salomon Nir, Yerushalmy-Feler Anat, Weintraub Yael, Yogev Dotan, Granot Maya, Haberman Yael, Ben-Horin Shomron, Weiss Batia
Pediatric Gastroenterology and Nutrition Unit, Edmond and Lily Safra Children's Hospital, Tel Hashomer, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
Front Pediatr. 2024 Sep 27;12:1342656. doi: 10.3389/fped.2024.1342656. eCollection 2024.
Curcumin and Qing Dai (QD) are herbal extracts that recently showed efficacy in treating inflammatory bowel disease (IBD). Since 2016, a combination of curcumin with QD (CurQD) has been employed in our center for management of active ulcerative colitis (UC).
We report the effectiveness and safety of CurQD therapy in children with mild-moderate UC or IBD-unclassified (IBD-U).
A multicenter retrospective study.
Children aged ≤OP18 years who were treated with CurQD during 2017-2021 were included. Disease activity measures were Pediatric UC Activity Index (PUCAI), and fecal calprotectin (FC). The primary outcome was a decrease in PUCAI by ≥10 points, FC normalization (≤100 µg/gr when baseline ≥300 µg/gr) or a ≥ 50% decrease in FC.
Of 30 patients (60% males, mean age 14 ± 3.9 years), 15 (50%), 13 (43%), and 2 (7%) had pancolitis, left-sided colitis and proctitis, respectively. The daily medication dose was 0.5-3 gm QD with 1-4 gm curcumin. Concomitant treatment at induction was corticosteroids (19%), biologics (28%) and 5-aminosalicylic acid (40%). The mean duration of induction was 11.6 weeks [95% confidence interval (CI) 10.2-13.1, range 8-16]. PUCAI decreased from a mean of 31.3 (95% CI 26.6-36.0, range 5-60) to 10.9 (95% CI 7.6-14.4, range 5-35) ( = 26, < 0.001). FC response and normalization occurred in 11/12 and 7/12 patients, respectively. The median decline in FC was from 749 µg/gm [interquartile range (IQR) 566-1000] to 39 µg/gm (IQR 12-132) ( = 15, = 0.04). During follow-up (median 8 months, IQR 6-10), 10 patients (33%) flared; five of them regained remission or responded to a treatment change. Of 18 patients treated beyond induction, 12 (67%) achieved clinical response and 10 achieved clinical remission by the end of follow up.
CurQD may be effective and safe as an add-on option to conventional management, for induction and maintenance in children with mild-moderate UC/IBD-U.
姜黄素和青黛是最近显示出对炎症性肠病（IBD）有治疗效果的草药提取物。自2016年以来，我们中心一直采用姜黄素与青黛的组合（CurQD）来治疗活动期溃疡性结肠炎（UC）。
我们报告CurQD疗法在轻度至中度UC或未分类IBD（IBD-U）儿童中的有效性和安全性。
一项多中心回顾性研究。
纳入2017年至2021年期间接受CurQD治疗的年龄≤18岁的儿童。疾病活动度指标为儿科UC活动指数（PUCAI）和粪便钙卫蛋白（FC）。主要结局是PUCAI降低≥10分、FC恢复正常（基线≥300μg/g时≤100μg/g）或FC降低≥50%。
30例患者（60%为男性，平均年龄14±3.9岁）中，分别有15例（50%）、13例（43%）和2例（7%）患有全结肠炎、左侧结肠炎和直肠炎。每日药物剂量为0.5 - 3g青黛和1 - 4g姜黄素。诱导期联合治疗包括使用皮质类固醇（19%）、生物制剂（28%）和5-氨基水杨酸（40%）。诱导期的平均持续时间为11.6周[95%置信区间（CI）10.2 - 13.1，范围8 - 16]。PUCAI从平均31.3（95%CI 26.6 - 36.0，范围5 - 60）降至10.9（95%CI 7.6 - 14.4，范围5 - 35）（P = 26，P < 0.001）。FC反应和恢复正常分别发生在11/12和7/12例患者中。FC的中位数下降幅度从749μg/g[四分位间距（IQR）566 - 1000]降至39μg/g（IQR 12 - 132）（P = 15，P = 0.04）。在随访期间（中位数8个月，IQR 6 - 10），10例患者（33%）复发；其中5例恢复缓解或对治疗调整有反应。在诱导期后接受治疗的18例患者中，12例（67%）在随访结束时达到临床反应，10例达到临床缓解。
对于轻度至中度UC/IBD-U儿童的诱导缓解和维持治疗，CurQD作为传统治疗的附加选择可能是有效且安全的。
