Osteoarthritis is a degenerative disease of the articular joints characterised by the breakdown of cartilage, joint lining, ligaments, and underlying bone and the disease manifests itself in stiffness and pain.
While current pharmacologic treatments such as analgesics and NSAIDs (Nonsteroidal anti-inflammatory drugs) provide symptomatic relief, such as relieving pain, they do not exert a clear clinical effect on OA disease prevention or modification. Additionally, in most cases, long-term use of these treatments has been associated with substantial gastrointestinal, renal, and cardiovascular side effects.
The current randomised, controlled clinical study involved 193 patients diagnosed with osteoarthritis of the knee. Patients were randomised to receive either BCM-95 turmeric extract from Arjuna Natural Pvt, Ltd. as a 500 mg capsule two times daily, or a 650 mg tablet of paracetamol three times daily for six weeks.
Knee arthritis symptoms of pain, joint stiffness, and diminished physical function were evaluated using the Western Ontario and Mc Master Universities Osteoarthritis Index (WOMAC).
After six weeks of treatment, responder analysis showed significant improvement in WOMAC scores across all parameters comparable to the paracetamol group, with 18% of the BCM-95 group reporting 50% improvement, and 3% of subjects noting 70% improvement.
These results were positively reflected in the BCM-95 group’s serum inflammatory markers: CRP levels were reduced by 37.21%, and TNF-α levels were cut by an impressive 74.81%, indicating BCM-95 performed better than paracetamol.
Nipen Lavingia, brand innovation advisor for Arjuna, said: “We are learning more about the mechanisms behind curcumin’s anti-inflammatory effect which we believe is a result of its ability to inhibit pro-inflammatory signals, such as prostaglandins, leukotrienes, and cyclooxygenase-2."
Benny Antony, PhD, joint managing director for Arjuna, added: "In addition, curcumin has been demonstrated to suppress several pro-inflammatory cytokines and mediators of their release, such as tumor necrosis factor-α (TNF-α), IL-1, IL-8, and nitric oxide synthase.”
Curcumin as an anti-inflammatory
Curcuminoids are the major phytoconstituents derived from the rhizomes of turmeric (Curcuma longa) containing three major components (curcumin, demethoxycurcumin, and bisdemethoxycurcumin).
Turmeric has a long history of being used in complementary and alternative medicine and is commonly taken for a variety for health conditions such as arthritis, gastrointestinal complaints, respiratory infections, and even cancer. There is some evidence that shows curcumin has anti-inflammatory, antithrombotic, antioxidant, and antimicrobial activities.
The anti-inflammatory effects of curcumin are believed to be a result of inhibiting pro-inflammatory signals such as prostaglandins, leukotrienes, and cyclooxygenase-2.
In addition, curcumin has been demonstrated to suppress several pro-inflammatory cytokines and mediators of their release such as tumor necrosis factor-α (TNF-α), IL-1, IL-8, and nitric oxide synthase.
Improving bioavailability
Being a highly lipophilic molecule, curcumin suffers from poor absorption and rapid metabolism in vivo, rendering it poorly bioavailable and hence limiting its biological effects.
The combination of curcuminoids with turmerones (essential oil components of turmeric) has been reported as a powerful tool in the prevention of inflammation and related symptoms. Synergistic effects of curcuminoids with sesquiterpenoids (mainly ar-turmerone) have also been studied by Nishiyama and co-workers for hypoglycemic effects. In a pilot crossover investigation in humans, the relative bioavailability of curcuminoid–essential oil complex was about 6.93-fold higher, compared with normal curcumin, and about 6.3-fold higher, compared with curcumin–lecithin–piperine formula.
BCM-95 comprises a mix of curcuminoids and turmerone-rich essential oil components and in a previous pilot crossover investigation in human volunteers, the relative bioavailability of Arjuna’s formulation was suggested to be over six times higher than standard curcumin.
Source: BMC Trials
Dhal. A., et al
"Bioavailable turmeric extract for knee osteoarthritis: a randomized, non-inferiority trial versus paracetamol"
