Effect of a combination of C. longa and B. serrata extracts on hand osteoarthritis. Results of a double-blind, randomized, placebo-controlled, multicenter trial.
Henrotin, Yves; de Schrijver, Frédéric; De Vlam, Kurtet al.
Boswellia; Clinical trial; Curcumin; Hand; Osteoarthritis; Rheumatology; Biomedical Engineering; Orthopedics and Sports Medicine
Résumé :
[en] [en] OBJECTIVE: To evaluate the efficacy and safety of a combination of patented C. longa and B. serrata extracts (CBTIL) in patients with hand osteoarthritis compared with placebo.
DESIGN: This 3-month, multicentre, randomized, double-blind, placebo-controlled study enrolled patients with symptomatic hand osteoarthritis, with a body mass index ≤ 35 Kg/m2, and who met the American College of Rheumatology criteria for osteoarthritis of the hand (CUBO/NCT05570123). Participants received either two tablets of CBTIL or two placebo tablets per day. The primary endpoint was the difference in pain change on the visual analog scale between baseline and month 3. Secondary outcomes included the number of painful and swollen joints, functional score, quality of life, patient global assessment, grip strength, analgesic consumption, and treatment tolerance.
RESULTS: 162 patients were randomly assigned to receive CBTIL (n=83) or placebo (n=79). In the Intention-to-treat analysis, the mean decrease (indicating pain relieve) from baseline to month 3 on the pain scale (primary endpoint) was -24.7 mm (95% Confidence Interval (CI) [-30.7 to -18.7]) in patient assigned to CBTIL group and -16.2 mm (95% CI [-22.5 to -9.9]) in patients assigned in placebo group (Difference between groups: -8.5 mm (95% CI [-16.4 to -0.6]; p = 0.03). At 3 months, the patient's global assessment (-9.6 mm [95% CI -16.9 to -2.2]), the percentage of patients achieving an acceptable symptom status (PASS) (Odd ratio (OR) 1.9 [95% CI 1.0 to 3.8]), Short Form-36 (SF-36) pain (7.1 units [95% CI 1.7 to 12.4]), and SF36 health change (6.7 units [95% CI 1.2 to 12.2]) were significantly improved by CBTIL compared to placebo. Other outcomes did not significantly differ between the two groups. No significant difference was observed regarding adverse events between the groups.
CONCLUSIONS: CBTIL relieves pain in patients with hand osteoarthritis. Together with its safety, this clinically relevant symptomatic effect suggests that CBTIL may be an alternative to oral NSAIDs and analgesics for managing symptomatic hand osteoarthritis.
Disciplines :
Rhumatologie
Auteur, co-auteur :
Henrotin, Yves ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation > Pathologie générale et physiopathologie - Techniques particulières de kinésithérapie
de Schrijver, Frédéric ; AZ Sint-Elisabeth Herentals, Herentals, Belgium. Electronic address: frederic.deschrijver@azherentals.be
De Vlam, Kurt ; UZ Leuven, Leuven, Belgium. Electronic address: kurt.devlam@uzleuven.be
Devinck, Mieke ; AZ St Lucas, Brugge, Belgium. Electronic address: Mieke.Devinck@stlucas.be
Joos, Rik ; ZNA Jan Palfijn, Antwerp, Belgium. Electronic address: rik.joos@zna.be
Luyten, Hilde; AZ St Lucas, Gand, Belgium. Electronic address: Hilde.Luyten@AZSTLUCAS.BE
Rasmont, Quentin ; Grand Hôpital de Charleroi, Charleroi, Belgium. Electronic address: Quentin.RASMONT@ghdc.be
Van den Berghe, Marthe ; ASZ Aalst, Alost, Belgium. Electronic address: Marthe.VanDenBerghe@asz.be
Vanhaverbeke, Tine ; Ghent University Hospital and Ghent University, Belgium. Electronic address: tine.vanhaverbeke@ugent.be
Vanhoof, Johan ; Reumaclinic, Genk, Belgium. Electronic address: johan@vanhoofjohan.be
Van Praet, Louis ; AZ Sint-Jan, Brugge, Belgium. Electronic address: Louis.VanPraet@azsintjan.be
Wittoek, Ruth ; Ghent University Hospital and Ghent University, Belgium. Electronic address: Ruth.Wittoek@UGent.be
Langue du document :
Anglais
Titre :
Effect of a combination of C. longa and B. serrata extracts on hand osteoarthritis. Results of a double-blind, randomized, placebo-controlled, multicenter trial.
Cross, M., Ong, K.L., Culbreth, G.T., Steinmetz, J.D., Cousin, E., Lenox, H., et al. Global, regional, and national burden of gout, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol 6:8 (2024 Aug 1), e507–e517 [cited 2024 Oct 28] 〈https://pubmed.ncbi.nlm.nih.gov/38996590/〉.
Richette, P., Latourte, A., Hand osteoarthritis: a fresh look. Joint Bone Spine 91:4 (2024 Jul 1), 1–7 [cited 2024 Oct 28] 〈https://pubmed.ncbi.nlm.nih.gov/37797830/〉.
Kloppenburg, M., Kroon, F.P.B., Blanco, F.J., Doherty, M., Dziedzic, K.S., Greibrokk, E., et al. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Ann Rheum Dis 78:1 (2019 Jan 1), 16–24 [cited 2024 Oct 28] 〈https://pubmed.ncbi.nlm.nih.gov/30154087/〉.
Liu, X., Machado, G.C., Eyles, J.P., Ravi, V., Hunter, D.J., Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis. Br J Sports Med 52:3 (2018 Feb 1), 167–175 [cited 2024 Oct 28] 〈https://pubmed.ncbi.nlm.nih.gov/29018060/〉.
Henrotin, Y., Dierckxsens, Y., Delisse, G., Maes, N., Albert, A., Curcuma longa and Boswellia serrata extract combination for hand osteoarthritis: an open-label pre-post trial. Pharm Biol 60:1 (2022), 2295–2299 [cited 2024 Oct 28] 〈https://pubmed.ncbi.nlm.nih.gov/36416059/〉.
Sanchez, C., Zappia, J., Lambert, C., Foguenne, J., Dierckxsens, Y., Dubuc, J.E., et al. Curcuma longa and Boswellia serrata extracts modulate different and complementary pathways on human chondrocytes in vitro: deciphering of a transcriptomic study. Front Pharmacol 13 (2022 Aug 11), 1–14 [cited 2024 Oct 29] 〈https://pubmed.ncbi.nlm.nih.gov/36034822/〉.
Lepage, L., Altman, D.G., Schulz, K.F., Moher, D., Egger, M., Davidoff, F., et al. The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Ann Intern Med 134:8 (2001 Apr 17), 663–694 [cited 2024 Oct 29] 〈https://pubmed.ncbi.nlm.nih.gov/11304107/〉.
Moher, D., Schulz, K.F., Altman, D.G., The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. J Am Podiatr Med Assoc 91:8 (2001), 437–442.
Pham, T., van der Heijde, D., Altman, R.D., Anderson, J.J., Bellamy, N., Hochberg, M., et al. OMERACT-OARSI initiative: osteoarthritis research society international set of responder criteria for osteoarthritis clinical trials revisited. Osteoarthritis Cartilage 12:5 (2004), 389–399 [cited 2024 Nov 18] 〈https://pubmed.ncbi.nlm.nih.gov/15094138/〉.
Henrotin, Y., Malaise, M., Wittoek, R., De Vlam, K., Brasseur, J.P., Luyten, F.P., et al. Bio-optimized Curcuma longa extract is efficient on knee osteoarthritis pain: a double-blind multicenter randomized placebo controlled three-arm study. Arthritis Res Ther, 21(1), 2019 Jul 27 [cited 2024 Oct 28] 〈https://pubmed.ncbi.nlm.nih.gov/31351488/〉.
Kizhakkedath, R., Clinical evaluation of a formulation containing Curcuma longa and Boswellia serrata extracts in the management of knee osteoarthritis. Mol Med Rep 8:5 (2013 Nov), 1542–1548 [cited 2024 Oct 28] 〈https://pubmed.ncbi.nlm.nih.gov/24002213/〉.
Wang, Z., Singh, A., Jones, G., Winzenberg, T., Ding, C., Chopra, A., et al. Efficacy and safety of turmeric extracts for the treatment of knee osteoarthritis: a systematic review and meta-analysis of randomised controlled trials. Curr Rheumatol Rep, 23(2), 2021 Feb 1 [cited 2025 Apr 5] 〈https://pubmed.ncbi.nlm.nih.gov/33511486/〉.
Døssing, A., Nielsen, S.M., Kroon, F.P.B., Balsby, I.M., Tarp, S., Kloppenburg, M., et al. Comparative effectiveness of pharmacological interventions for hand osteoarthritis: a systematic review and network meta-analysis of randomised trials. RMD Open, 9(3), 2023 Sep 21 [cited 2024 Oct 28] 〈https://pubmed.ncbi.nlm.nih.gov/37734873/〉.
Mathy-Hartert, M., Jacquemond-Collet, I., Priem, F., Sanchez, C., Lambert, C., Henrotin, Y., Curcumin inhibits pro-inflammatory mediators and metalloproteinase-3 production by chondrocytes. Inflamm Res 58:12 (2009 Dec), 899–908 [cited 2024 Oct 28] 〈https://pubmed.ncbi.nlm.nih.gov/19579007/〉.
Zhi, L., Dong, L., Kong, D., Sun, B., Sun, Q., Grundy, D., et al. Curcumin acts via transient receptor potential vanilloid-1 receptors to inhibit gut nociception and reverses visceral hyperalgesia. Neurogastroenterol Motil 25:6 (2013 Jun), e429–e440 [cited 2024 Oct 28] 〈https://pubmed.ncbi.nlm.nih.gov/23638900/〉.
Shin, M.R., Kim, H.Y., Choi, H.Y., Park, K.S., Choi, H.J., Roh, S.S., Boswellia serrata Extract, 5-Loxin®, prevents joint pain and cartilage degeneration in a rat model of osteoarthritis through inhibition of inflammatory responses and restoration of matrix homeostasis. Evid Based Complement Alternat Med, 2022, 2022, 3067526 [cited 2024 Oct 28] 〈https://pubmed.ncbi.nlm.nih.gov/36310623/〉.