Safety and efficacy of curcumin in the treatment of ulcerative colitis: An updated systematic review and meta-analysis of randomized controlled trials.

Zhao Peng, Duo Li, Na Wu, Xiao-Yuan Wang, Gai-Xia Sun, Hui-Bin Gao, Hai-Xia Li

Journal: Explore (New York, N.Y.) 2025;21(1):103083

PMID: 39612780

Free Full Text on Elsevier Science View on PubMed

Plain Language Summary

Ulcerative colitis (UC) is a chronic autoimmune disease characterised by inflammatory lesions in the gastrointestinal tract, primarily affecting the colonic mucosa. This study aimed to assess the effectiveness and safety of curcumin as a therapeutic component for the treatment of UC patients. This research was an updated systematic review and meta-analysis of eight studies. Results showed that: - patients treated with curcumin showed a significant increase in clinical remission compared to the control group, but no significant difference was observed in endoscopic remission; - curcumin supplementation, compared to placebo, was associated with significant improvements in clinical improvement and endoscopic improvement; - curcumin did not increase the risk of serious adverse events compared to placebo. Authors concluded that curcumin as a supplementary treatment, when used in addition to standard therapy, may be beneficial in increasing clinical remission, clinical improvement, and endoscopic improvement in patients with ulcerative colitis compared to placebo, with no significant increase in serious adverse effects.

Abstract

OBJECTIVE

This study aims to systematically evaluate the safety and efficacy of curcumin as an adjunctive treatment for patients with ulcerative colitis (UC) and to assess the methodological quality of the published studies.

METHODS

A comprehensive search was conducted in PubMed, Embase, and CENTRAL databases for randomized controlled trials published up to August 18, 2023. Two independent reviewers screened studies based on predefined criteria. Meta-analysis was performed using a random-effects model with RevMan 5.4. Heterogeneity was assessed using Cochran's Q test and I² statistic.

RESULTS

Eight randomized controlled trials involving 482 patients were included. Seven studies reported clinical remission, and three reported endoscopic remission. Compared to the placebo group, adjunctive curcumin therapy significantly improved clinical remission (RR=2.33, 95 % CI: 1.25 to 4.34; P = 0.008; I²=80 %). Although endoscopic remission showed an increasing trend, it was not statistically significant (RR=4.17, 95 % CI: 0.63 to 27.71; P = 0.14; I²=80 %). Significant improvements were also observed in clinical improvement (RR=1.93, 95 % CI: 1.10 to 3.36; P = 0.02; I²=56 %) and endoscopic improvement (RR=1.76, 95 % CI: 1.12 to 2.77; P = 0.01; I²=62 %) in the curcumin group. No serious adverse events were reported. Subgroup analysis indicated a positive correlation between treatment efficacy and dosage, with no significant impact of administration method or follow-up duration on the pooled results or heterogeneity.

CONCLUSION

Curcumin as an adjunctive treatment shows promise in improving clinical and endoscopic outcomes in UC patients without significant adverse effects. However, due to the limited number of studies and substantial heterogeneity, further large-scale randomized controlled trials are necessary to confirm these findings.

Address: Department of Gastroenterology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075000, China. Electronic address: [email protected].; Department of Gastroenterology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075000, China.

DOI: 10.1016/j.explore.2024.103083