Skip to main content
SpringerLink
Log in

The Clinical Use of Curcumin for the Treatment of Rheumatoid Arthritis: A Systematic Review of Clinical Trials

  • Chapter
  • First Online:
Studies on Biomarkers and New Targets in Aging Research in Iran

Part of the book series: Advances in Experimental Medicine and Biology ((PMISB,volume 1291))

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints, which is prevalent in about 0.5–1.0% of the world population. Newer therapies for RA have only minimal efficacy in some cases and some adverse effects. Curcumin with anti-antioxidant, anti-inflammatory, and immunomodulatory properties might have beneficial effects on RA. We have carried out a systematic review with the main aim of estimating the effect of curcumin supplementation on RA. A systematic search of the medical databases, PubMed, Scopus, ISI, and Google Scholar was performed up to March 21, 2020 to identify clinical trials assessing the effect of turmeric or curcumin on RA. Six studies, comprising 259 patients with RA of 6–12 weeks duration, were included. Disease activity was assessed using 28 joints (DAS-28), visual analog scale (VAS), and American College of Rheumatology (ACR-20) scores. Treatment with curcumin significantly reduced DAS-28 scores in four out of five studies and VAS scores for pain in all three studies and significantly increased ACR-20 scores in all three studies in which it was measured. Erythrocyte sedimentation rate (ESR) and circulating C-reactive protein (CRP) were assessed in six and five studies, respectively, out of which four studies reported significant reductions in these parameters in response to curcumin treatment. Rheumatoid factor (RF) was significantly reduced after consumption of curcumin in all three relevant studies. None of the studies reported serious adverse effects with curcumin consumption. The present systematic review suggests that curcumin could be used as a safe agent to treat RA. Thus, further validation is justified.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Firestein GS (2003) Evolving concepts of rheumatoid arthritis. Nature 423(6937):356–361

    Article  CAS  PubMed  Google Scholar 

  2. Symmons DP (2002) Epidemiology of rheumatoid arthritis: determinants of onset, persistence and outcome. Best Pract Res Clin Rheumatol 16(5):707–722

    Article  PubMed  Google Scholar 

  3. Symmons D, Mathers C, Pfleger B (2006) The global burden of rheumatoid arthritis in the year 2000. https://www.who.int/healthinfo/statistics/bod_rheumatoidarthritis.pdf

  4. Oliveira RAD, Fierro IM (2018) New strategies for patenting biological medicines used in rheumatoid arthritis treatment. Expert Opin Ther Pat 28(8):635–646

    Article  CAS  PubMed  Google Scholar 

  5. Cooper N (2000) Economic burden of rheumatoid arthritis: a systematic review. Rheumatology (Oxford) 39(1):28–33

    Article  CAS  Google Scholar 

  6. Haroon N, Aggarwal A, Lawrence A, Agarwal V, Misra R (2007) Impact of rheumatoid arthritis on quality of life. Mod Rheumatol 17(4):290–295

    Article  PubMed  Google Scholar 

  7. Paul B, Pariyapurath R (2018) Risk factor assessment of rheumatoid arthritis in North Kerala. Eur J Rheumatol 5(3):184–190

    Article  PubMed  PubMed Central  Google Scholar 

  8. Bullock J, Rizvi SA, Saleh AM, Ahmed SS, Do DP, Ansari RA et al (2018) Rheumatoid arthritis: a brief overview of the treatment. Med Prin Pract 27(6):501–507

    Article  Google Scholar 

  9. Quan L-D, Thiele GM, Tian J, Wang D (2008) The development of novel therapies for rheumatoid arthritis. Expert Opin Ther Pat 18(7):723–738

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Efthimiou P, Kukar M (2010) Complementary and alternative medicine use in rheumatoid arthritis: proposed mechanism of action and efficacy of commonly used modalities. Rheumatol Int 30(5):571–586

    Article  PubMed  Google Scholar 

  11. Bagherniya M, Nobili V, Blesso CN, Sahebkar A (2018) Medicinal plants and bioactive natural compounds in the treatment of non-alcoholic fatty liver disease: a clinical review. Pharmacol Res 130:213–240

    CAS  PubMed  Google Scholar 

  12. Fahira A, Soraya A, Achmadsyah A, Hakim RW (2019) Efficacy and safety of Curcuma longa extract in the treatment of osteoarthritis: a systematic review. Int J Appl Pharm 11:140–145

    Article  CAS  Google Scholar 

  13. Abdollahi E, Momtazi AA, Johnston TP, Sahebkar A (2018) Therapeutic effects of curcumin in inflammatory and immune-mediated diseases: a nature-made jack-of-all-trades? J Cell Physiol 233(2):830–848

    Article  CAS  PubMed  Google Scholar 

  14. Pari L, Tewas D, Eckel J (2008) Role of curcumin in health and disease. Arch Physiol Biochem 114(2):127–149

    Article  CAS  PubMed  Google Scholar 

  15. Mollazadeh H, Cicero AFG, Blesso CN, Pirro M, Majeed M, Sahebkar A (2019) Immune modulation by curcumin: the role of interleukin-10. Crit Rev Food Sci Nutr 59(1):89–101

    CAS  PubMed  Google Scholar 

  16. Teymouri M, Pirro M, Johnston TP, Sahebkar A (2017) Curcumin as a multifaceted compound against human papilloma virus infection and cervical cancers: A review of chemistry, cellular, molecular, and preclinical features. BioFactors 43(3):331–346 

    Google Scholar 

  17. Momtazi AA, Derosa G, Maffioli P, Banach M, Sahebkar A (2016) Role of microRNAs in the therapeutic effects of curcumin in non-cancer diseases. Mol Diagn Ther 20(4):335–345

    Google Scholar 

  18. Soleimani V, Sahebkar A, Hosseinzadeh H (2018) Turmeric (Curcuma longa) and its major constituent (curcumin) as nontoxic and safe substances: Review. Phytother Res 32(6):985–995. https://doi.org/10.1002/ptr.6054. Epub 2018 Feb 26. PMID: 29480523

  19. Sun YM, Wang RX, Yuan SL, Lin XJ, Liu CB (2004) Theoretical study on the antioxidant activity of curcumin. Chin J Chem 22(8):827–830

    Article  CAS  Google Scholar 

  20. Srimal R, Dhawan B (1973) Pharmacology of diferuloyl methane (curcumin), a non-steroidal anti-inflammatory agent. J Pharm Pharmacol 25(6):447–452

    Article  CAS  PubMed  Google Scholar 

  21. Hasanzadeh S, Read MI, Bland AR, Majeed M, Jamialahmadi T, Sahebkar A (2020) Curcumin: an inflammasome silencer. Pharmacol Res 159:104921. https://doi.org/10.1016/j.phrs.2020.104921. Epub 2020 May 25. PMID: 32464325.

  22. Fagbemi FJ, Ugoji E, Adenipekun T et al (2009) Evaluation of the antimicrobial properties of unripe banana (Musa sapientum L.), lemon grass (Cymbopogon citratus S.) and turmeric (Curcuma longa L.) on pathogens. Afr J Biotechnol 8(7):1176–1182

    Google Scholar 

  23. Forouzanfar F, Read MI, Barreto GE, Sahebkar A (2020) Neuroprotective effects of curcumin through autophagy modulation. IUBMB Life 72(4):652–664. https://doi.org/10.1002/iub.2209. Epub 2019 Dec 5. PMID: 31804772

  24. Bagheri H, Ghasemi F, Barreto GE, Rafiee R, Sathyapalan T, Sahebkar A (2020) Effects of curcumin on mitochondria in neurodegenerative diseases. Biofactors 46(1):5–20. https://doi.org/10.1002/biof.1566. Epub 2019 Oct 3. PMID: 31580521

  25. Iranshahi M, Sahebkar A, Hosseini ST, Takasaki M, Konoshima T, Tokuda H (2010) Cancer chemopreventive activity of diversin from Ferula diversivittata in vitro and in vivo. Phytomedicine 17(3–4):269–73. https://doi.org/10.1016/j.phymed.2009.05.020. Epub 2009 Jul 3. PMID: 19577457

  26. Momtazi AA, Sahebkar A (2016) Difluorinated curcumin: a promising curcumin analogue with improved anti-tumor activity and pharmacokinetic profile. Curr Pharm Des 22(28):4386–4397

    Article  CAS  PubMed  Google Scholar 

  27. Mohajeri M, Bianconi V, Ávila-Rodriguez MF, Barreto GE, Jamialahmadi T, Pirro M, Sahebkar A (2020) Curcumin: a phytochemical modulator of estrogens and androgens in tumors of the reproductive system. Pharmacol Res 156:104765. https://doi.rg/10.1016/j.phrs.2020.104765. Epub 2020 Mar 23. PMID: 32217147

  28. Srivastava RM, Singh S, Dubey SK, Misra K, Khar A (2011) Immunomodulatory and therapeutic activity of curcumin. Int Immunopharmacol 11(3):331–341

    Article  CAS  PubMed  Google Scholar 

  29. Amalraj A, Varma K, Jacob J, Divya C, Kunnumakkara AB, Stohs SJ et al (2017) A novel highly bioavailable curcumin formulation improves symptoms and diagnostic indicators in rheumatoid arthritis patients: a randomized, double-blind, placebo-controlled, two-dose, three-arm, and parallel-group study. J Med Food 20(10):1022–1030

    Article  CAS  PubMed  Google Scholar 

  30. Jacob J, Amalraj A, Raj KJ, Divya C, Kunnumakkara AB, Gopi S (2019) A novel bioavailable hydrogenated curcuminoids formulation (CuroWhite™) improves symptoms and diagnostic indicators in rheumatoid arthritis patients: a randomized, double blind and placebo controlled study. J Tradit Complement Med 9(4):346–352

    Article  PubMed  Google Scholar 

  31. Chandran B, Goel A (2012) A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis. Phytother Res 26(11):1719–1725

    Article  CAS  PubMed  Google Scholar 

  32. Hemmati AA, Rajaee E, Houshmand G, Fakhroddin MA, Dargahi-MalAmir M, Hesam S et al (2016) Study the effects of anti-inflammatory curcumex capsules containing three plants (ginger, curcumin and black pepper) in patients with active rheumatoid arthritis. IIOAB J 7:389–392

    Google Scholar 

  33. Javadi M, Khadem Haghighian H, Goodarzy S, Abbasi M, Nassiri-Asl M (2019) Effect of curcumin nanomicelle on the clinical symptoms of patients with rheumatoid arthritis: a randomized, double-blind, controlled trial. Int J Rheum Dis 22(10):1857–1862

    Article  CAS  PubMed  Google Scholar 

  34. Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151(4):264–269

    PubMed  Google Scholar 

  35. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ et al (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17(1):1–12

    CAS  PubMed  Google Scholar 

  36. Moher D, Cook D, Jadad A, Tugwell P, Moher M, Jones A et al (1999) Assessing the quality of reports of randomised trials: implications for the conduct of meta-analyses. Health Technol Assess 3(12):i–iv. 1–98

    CAS  PubMed  Google Scholar 

  37. Anusha D, Chaly P, Junaid M, Nijesh J, Shivashankar K, Sivasamy S (2019) Efficacy of a mouthwash containing essential oils and curcumin as an adjunct to nonsurgical periodontal therapy among rheumatoid arthritis patients with chronic periodontitis: a randomized controlled trial. Indian J Dent Res 30(4):506–511

    Article  PubMed  Google Scholar 

  38. Radner H, Lesperance T, Accortt NA, Solomon DH (2017) Incidence and prevalence of cardiovascular risk factors among patients with rheumatoid arthritis, psoriasis, or psoriatic arthritis. Arthritis Care Res (Hoboken) 69(10):1510–1518

    Article  Google Scholar 

  39. Iaquinta M, McCrone S (2015) An integrative review of correlates and predictors of depression in patients with rheumatoid arthritis. Arch Psychiatr Nurs 29(5):265–278

    Article  PubMed  Google Scholar 

  40. Matcham F, Ali S, Irving K, Hotopf M, Chalder T (2016) Are depression and anxiety associated with disease activity in rheumatoid arthritis? A prospective study. BMC Musculoskelet Disord 17:155. https://doi.org/10.1186/s12891-016-1011-1

    Article  PubMed  PubMed Central  Google Scholar 

  41. Rezaei F, Doost HTN, Molavi H, Abedi MR, Karimifar M (2014) Depression and pain in patients with rheumatoid arthritis: mediating role of illness perception. Egypt Rheumatol 36(2):57–64

    Article  Google Scholar 

  42. Tander B, Cengiz K, Alayli G, İlhanli İ, Canbaz S, Canturk F (2008) A comparative evaluation of health related quality of life and depression in patients with fibromyalgia syndrome and rheumatoid arthritis. Rheumatol Int 28(9):859–865

    Article  PubMed  Google Scholar 

  43. Deighton C, O’Mahony R, Tosh J, Turner C, Rudolf M (2009) Management of rheumatoid arthritis: summary of NICE guidance. BMJ 338:b702. https://doi.org/10.1136/bmj.b702

    Article  PubMed  PubMed Central  Google Scholar 

  44. Guo Q, Wang Y, Xu D, Nossent J, Pavlos NJ, Xu J (2018) Rheumatoid arthritis: pathological mechanisms and modern pharmacologic therapies. Bone Res 6:1):1–1)14

    Article  CAS  Google Scholar 

  45. Wei Z, Liu N, Tantai X, Xing X, Xiao C, Chen L et al (2019) The effects of curcumin on the metabolic parameters of non-alcoholic fatty liver disease: a meta-analysis of randomized controlled trials. Hepatol Int 13(3):302–313

    Article  PubMed  Google Scholar 

  46. Sahebkar A (2013) Why it is necessary to translate curcumin into clinical practice for the prevention and treatment of metabolic syndrome? BioFactors 39(2):197–208

    Article  CAS  PubMed  Google Scholar 

  47. Qin S, Huang L, Gong J, Shen S, Huang J, Ren H et al (2017) Efficacy and safety of turmeric and curcumin in lowering blood lipid levels in patients with cardiovascular risk factors: a meta-analysis of randomized controlled trials. Nutr J 16(1):68. https://doi.org/10.1186/s12937-017-0293-y

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Hadi A, Pourmasoumi M, Ghaedi E, Sahebkar A (2019) The effect of Curcumin/Turmeric on blood pressure modulation: a systematic review and meta-analysis. Pharmacol Res 150:104505. https://doi.org/10.1016/j.phrs.2019.104505

    Article  CAS  PubMed  Google Scholar 

  49. Poolsup N, Suksomboon N, Kurnianta PDM, Deawjaroen K (2019) Effects of curcumin on glycemic control and lipid profile in prediabetes and type 2 diabetes mellitus: a systematic review and meta-analysis. PLoS One 14(4):e0215840. https://doi.org/10.1371/journal.pone.0215840

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Libby P (2008) Role of inflammation in atherosclerosis associated with rheumatoid arthritis. Am J Med 121(10):S21–S31

    Article  CAS  PubMed  Google Scholar 

  51. McInnes IB, Schett G (2007) Cytokines in the pathogenesis of rheumatoid arthritis. Nat Rev Immunol 7(6):429–442

    Article  CAS  PubMed  Google Scholar 

  52. Sahebkar A, Cicero AF, Simental-Mendía LE, Aggarwal BB, Gupta SC (2016) Curcumin downregulates human tumor necrosis factor-α levels: a systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 107:234–242

    Article  CAS  PubMed  Google Scholar 

  53. Sahebkar A (2014) Are curcuminoids effective C-reactive protein-lowering agents in clinical practice? Evidence from a meta-analysis. Phytother Res 28(5):633–642

    Article  CAS  PubMed  Google Scholar 

  54. Derosa G, Maffioli P, Simental-Mendia LE, Bo S, Sahebkar A (2016) Effect of curcumin on circulating interleukin-6 concentrations: a systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 111:394–404

    Article  CAS  PubMed  Google Scholar 

  55. Ghandadi M, Sahebkar A (2017) Curcumin: an effective inhibitor of interleukin-6. Curr Pharm Des 23(6):921–931

    Article  CAS  PubMed  Google Scholar 

  56. Sokolove J, Johnson DS, Lahey LJ, Wagner CA, Cheng D, Thiele GM et al (2014) Rheumatoid factor as a potentiator of anti–citrullinated protein antibody–mediated inflammation in rheumatoid arthritis. Arthritis Rheum 66(4):813–821

    Article  CAS  Google Scholar 

  57. Bovin LF, Rieneck K, Workman C, Nielsen H, Sørensen SF, Skjødt H et al (2004) Blood cell gene expression profiling in rheumatoid arthritis: discriminative genes and effect of rheumatoid factor. Immunol Lett 93(2–3):217–226

    Article  CAS  PubMed  Google Scholar 

  58. Yadav V, Mishra K, Singh D, Mehrotra S, Singh V (2005) Immunomodulatory effects of curcumin. Immunopharmacol Immunotoxicol 27(3):485–497

    Article  CAS  PubMed  Google Scholar 

  59. Daily JW, Yang M, Park S (2016) Efficacy of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: a systematic review and meta-analysis of randomized clinical trials. J Med Food 19(8):717–729

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Fransen J, Stucki G, van Riel PL (2003) Rheumatoid arthritis measures: disease activity score (DAS), disease activity score-28 (DAS28), rapid assessment of disease activity in rheumatology (RADAR), and rheumatoid arthritis disease activity index (RADAI). Arthritis Care Res 49(S5):S214–S224

    Article  Google Scholar 

  61. Zhang JM, An J (2007) Cytokines, inflammation, and pain. Int Anesthesiol Clin 45(2):27–37

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Longoni M, Ferrarese C (2006) Inflammation and excitotoxicity: role in migraine pathogenesis. Neurol Sci 27(Suppl. 2):S107–S110

    Article  PubMed  Google Scholar 

  63. Mittal N, Joshi R, Hota D, Chakrabarti A (2009) Evaluation of antihyperalgesic effect of curcumin on formalin-induced orofacial pain in rat. Phytother Res 23(4):507–512

    Article  CAS  PubMed  Google Scholar 

  64. Banafshe HR, Hamidi GA, Noureddini M, Mirhashemi SM, Mokhtari R, Shoferpour M (2014) Effect of curcumin on diabetic peripheral neuropathic pain: possible involvement of opioid system. Eur J Pharmacol 723:202–206

    Article  CAS  PubMed  Google Scholar 

  65. Sharma S, Chopra K, Kulkarni SK (2007) Effect of insulin and its combination with resveratrol or curcumin in attenuation of diabetic neuropathic pain: participation of nitric oxide and TNF-alpha. Phytother Res 21(3):278–283

    Article  CAS  PubMed  Google Scholar 

  66. Sharma S, Kulkarni SK, Agrewala JN, Chopra K (2006) Curcumin attenuates thermal hyperalgesia in a diabetic mouse model of neuropathic pain. Eur J Pharmacol 536(3):256–261

    Article  CAS  PubMed  Google Scholar 

  67. Li Y, Zhang Y, Liu DB, Liu HY, Hou WG, Dong YS (2013) Curcumin attenuates diabetic neuropathic pain by downregulating TNF-α in a rat model. Int J Med Sci 10(4):377–381

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Lopresti AL (2018) The problem of curcumin and its bioavailability: could its gastrointestinal influence contribute to its overall health-enhancing effects? Adv Nutr 9(1):41–50

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

    Mohammad Bagherniya & Gholamreza Askari

  2. Students’ Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran

    Mina Darand

  3. Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil

    Paul C. Guest

  4. Department of Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK

    Thozhukat Sathyapalan

  5. Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran

    Amirhossein Sahebkar

  6. Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Amirhossein Sahebkar

  7. Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland

    Amirhossein Sahebkar

  8. Halal Research Center of IRI, FDA, Tehran, Iran

    Amirhossein Sahebkar

Authors
  1. Mohammad Bagherniya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mina Darand
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gholamreza Askari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paul C. Guest
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Thozhukat Sathyapalan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Amirhossein Sahebkar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amirhossein Sahebkar .

Editor information

Editors and Affiliations

  1. University of Campinas, Sao Paulo, Brazil

    Paul C. Guest

Rights and permissions

Reprints and permissions

Copyright information

© 2021 The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Bagherniya, M., Darand, M., Askari, G., Guest, P.C., Sathyapalan, T., Sahebkar, A. (2021). The Clinical Use of Curcumin for the Treatment of Rheumatoid Arthritis: A Systematic Review of Clinical Trials. In: Guest, P.C. (eds) Studies on Biomarkers and New Targets in Aging Research in Iran. Advances in Experimental Medicine and Biology(), vol 1291. Springer, Cham. https://doi.org/10.1007/978-3-030-56153-6_15

Download citation

Publish with us

Policies and ethics

Search

Navigation