Tumeric or curcumin and the treatment of knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials
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Résumé
Background: The prevalence of knee osteoarthritis (OA) is on the rise globally. This is partly due to the increase in proportion of people aged 60 years and older worldwide. Many of the current therapeutic options for the management of knee OA used in conventional medical practice have undesirable side effects which has led researchers to consider effective and safer alternatives. Curcumin, an herbal medicinal extract from the rhizome – turmeric has a favorable safety profile, and research evidence suggests that it is a viable option for the treatment of knee OA.\n\nObjective: The objective of this systematic review and meta-analysis was to summarize and critically evaluate the published evidence from randomized controlled trials (RCTs) on the efficacy of curcumin in treating knee OA. \n\nMethods: PubMed and Embase were searched for relevant RCTs published up until April 8, 2020. All RCTs that investigated the efficacy or effectiveness of curcumin in treating knee OA were included. Heterogeneity was assessed using I2 statistics, and the random effects models were selected to calculate weighted mean differences (WMD) and mean change differences (MCD) for the outcome measures – visual analog scale (VAS) and Western Ontario and McMaster Osteoarthritis Index (WOMAC) scores.\n\nResults: Ten RCTs (n = 1272) were included in the meta-analysis. Curcumin significantly reduced pain (WMD for VAS (n = 3): -16.76 (-25.41, -8.11), I2 = 87.6%, Pheterogeneity = <0.001) and improved physical function (WMD for WOMAC physical function (n = 3): -8.63 (-10.17, -7.09), I2 = 0.0%, Pheterogeneity = 0.443) when compared with placebo. There was no difference in physical function (WMD for WOMAC physical function (n = 1): 0.15 (-0.30, 0.60), I2 = 0.0%, Pheterogeneity = .) when compared to ibuprofen or pain reduction (WMD for VAS (n=1): 0.00 (-0.24, 0.24), I2 = 0.0%, Pheterogeneity = .) when compared to diclofenac. Furthermore, sub-group analysis showed that difference in curcumin dosage (stronger association in doses >1000 mg/d) and type of control (RCTs with curcumin vs. active medication reported effect estimates closer to the null value) contributed significantly to the heterogeneity between the studies. Lastly, the incidence of adverse events was similar between curcumin and placebo but lower in the curcumin group when compared with active controls. \n\nConclusion: The findings from this review suggests that curcumin is a safe and effective option for treating the symptoms of knee OA. However, the number of RCTs included in the analysis along with their overall quality and the total sample size was not sufficient to draw firm conclusions. Further high quality RCTs with large sample sizes should be conducted in order to provide definitive evidence that allow the adoption of curcumin as a treatment for knee OA in clinical practice.
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Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,009 | 0,003 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle