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Efficacy and Safety of Liposomal Curcumin in the Management of Pain due to Osteoarthritis


Affiliations
1 Proprietor, Shreepad Shree Vallabh, SSV Phytopharmaceuticals, India
2 Consultant Orthopedist, Vakratund Hospital Pvt Ltd, PathardiPhata, Nashik, India
     

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Aims and Background: The most prevalent chronic joint disease, which remains as one of the few chronic disorders of ageing is Osteoarthritis (OA). One of the predominant symptoms of OA is pain, with very little effective treatment and contributes to limitations in daily functioning. Therapy of pain due to OA includes pharmaceutical agents that need to be used in lowest possible dose to avoid adverse effects. Lot of advances have taken place in understanding the pathogenesis of OA, however, relief of pain have always remained an unfulfilled need. The anti-inflammatory property of Curcumin is mediated through the inhibition of induction of COX-2, LOX, iNOS and production of cytokines and tumor necrosis factor and activation of transcription factors like NF-κB, and AP-1. Its oral bioavailability is extremely poor.

Material and Methods: In the current study, Liposomal Curcumin was administered to 30 patients suffering from pain due to OA for 30 days. The therapeutic activity was assessed by reduction in the pain severity based on NPRS Score.

Results: By 30 days, there was statistically significant decrease in NPRS score. The pain reduced significantly along with decrease in weakness and fatigue. Improvement in daily physical functioning was shown by the WOMAC Arthritis Index. In 10 subjects the serum levels of Interleukin-6 (IL-6) and Tumour Necrosis Factor (TNF)α were examined at baseline and at 30th day. There was 76% improvement in TNF-α levels and 62% improvement in IL-6 levels in these subjects.

Conclusion: These results have shown for the first time in Indian population the efficacy of Liposomal Curcumin for OA Pain.


Keywords

Osteoarthritis, Pain, Liposomal Curcumin, Anti-Inflammatory.
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  • Cross M, Smith E, Hoy D, et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(7):1323-30.

  • U.S. Census Bureau. International data base [Internet]. Washington, DC: U.S. Census Bureau; 2016 [cited 2015 Sep 3]. Available from: http://www.census.gov/ population/ international/data/idb/region.php?N=%20Results%20&T=13&A=both&RT=0&Y=2015&R=1&C=.

  • Haq SA, Davatchi F. Osteoarthritis of the knees in the COPCORD world. Int J Rheum Dis. 2011;14(2):122-9.

  • Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH, et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum.1998;41:778–99.

  • Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med.2010;26:355–69.

  • Hadler NM. Knee pain is the malady--not osteoarthritis. Ann Intern Med. 1992; 116:598–9.

  • Ayis S, Dieppe P. The natural history of disability and its determinants in adults with lower limb musculoskeletal pain. J Rheumato. l2009; 36:583–91.

  • Dominick KL, Ahern FM, Gold CH, Heller DA. Health-related quality of life and health service use among older adults with osteoarthritis. Arthritis Rheum. 2004; 51:326–31.

  • McAlindon TE, Cooper C, Kirwan JR, Dieppe PA. Determinants of disability in osteoarthritis of the knee. Ann Rheum Dis. 1993; 52:258–62.

  • Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole MR. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001 Nov;94(2):149-158..

  • Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988; 15:1833–40.

  • Miller JM, Thompson JK, MacPherson MB, Beuschel SL, Westbom CM, Sayan M, et al. Curcumin: a double hit on malignant mesothelioma. Cancer Prev Res (Phila). 2014; 7: 330-40.

  • Anand, P., Sundaram, C., Jhurani, S., Kunnumakkara, A. B., and Aggarwal, B. B. (2008). Curcumin and cancer: an “old-age” disease with an “age-old” solution. CancerLett. 267, 133–164.

  • Kunnumakkara, A. B., Anand,P., and Aggarwal,B. B. (2008). Curcumin inhibits proliferation, invasion, angiogenesis and metastasis of different cancers through interaction with multiple cell signalling proteins. CancerLett. 269, 199–225.

  • Hussain Z, Thu HE, Amjad MW, Hussain F, Ahmed TA, Khan S. Exploring recent developments to improve antioxidant, anti-inflammatory and antimicrobial efficacy of curcumin: A review of new trends and future perspectives. Mater Sci Eng C Mater Biol Appl. 2017; 77: 1316-26.

  • Wahlang, B., Pawar, Y. B., and Bansal, A. K. (2011). Identification of permeability related hurdles in oral delivery of curcumin using the CaCo-2 cell model. Eur. J. Pharm. Biopharm. 77, 275–282.

  • Liu A, Lou H, Zhao L, Fan P (2006) Validated LC/MS/MS assay for curcumin and tetrahydrocurcumin in rat plasma and application to pharmacokinetic study of phospholipid complex of curcumin. J Pharm Biomed Anal 40(3):720–727.

  • Perrot S. Osteoarthritis pain. Best Pract Res Clin Rheumatol. 2015 Feb;29(1):90-7.

  • Venugopal P. Menon and Adluri Ram Sudheer. Antioxidant And Anti-Inflammatory Properties Of Curcumin. Adv Exp Med Biol. 2007;595:105-25.

  • Panahi Y., Hosseini M.S., Khalili N., Naimi E., Simental-Mendia L.E., Majeed M., Sahebkar A. Effects of curcumin on serum cytokine concentrations in subjects with metabolic syndrome: A post-hoc analysis of a randomized controlled trial. Biomed. Pharmacother. 2016;82:578–582.

  • Xu XY, Meng X, Li S, et al. Bioactivity, health benefits, and related molecular mechanisms of curcumin: current progress, challenges, and perspectives. Nutrients 2018;10:pii:E1553.

  • Ghosh S, Banerjee S, Sil PC. The beneficial role of curcumin on inflammation, diabetes and neurodegenerative disease: A recent update. Food Chem Toxicol 2015;83:111–24.

  • T. Kawamori, C. V. Rao, K. Seibert, and B. S. Reddy, Chemopreventive activity of celecoxib, a specific cyclooxygenase-2 inhibitor, against colon carcinogenesis. Cancer Res 58, 409–412 (1998).

  • I. Brouet and H. Ohshima, Curcumin, an anti-tumor promoter and anti-inflammatory agent, inhibits induction of nitric oxide synthase in activated macrophages. Biochem Biophys Res Commun206, 533–540 (1995).

  • S. Shishodia, H. M. Amin, R. Lai, and B. B. Aggarwal, Curcumin (diferuloylmethane) inhibits constitutive NF-kappaB activation, induces G1/S arrest, suppresses proliferation, and induces apoptosis in mantle cell lymphoma. Biochem Pharmacol 70(5), 700–713 (2005).

  • James W. Daily, Mini Yang and Sunmin Park. 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) 2016, 717–729.

  • Maria Goulart, Daniela Partar, Luis Cunha, Stevin Zung. Curcumin in osteoarthritis treatment: the present state of evidence. 2019. Ann Rheum Dis. (6): 1867.

  • Shep D, Khanwelkar C, Gade P and Karad S. Safety and efficacy of curcumin versus diclofenac in knee osteoarthritis: a randomized open-label parallel-arm study. Trials (2019) 20:214.

  • Zhang Z, X Leong DJ, Xu L et al. Curcumin slows osteoarthritis progression and relieves osteoarthritis-associated pain symptoms in a post-traumatic osteoarthritis mouse model. Arthritis Research & Therapy (2016) 18:128.

  • Guowang Zhang, Jiaqing Cao, Erzhu Yang et al. Curcumin improves age-related and surgically induced osteoarthritis by promoting autophagy in mice. Bioscience Reports (2018) 38.

  • Canamares, M. V., Garcia-Ramos, J. V., and Sanchez-Cortes, S. (2006). Degradation of curcumin dye in aqueous solution and on Ag nanoparticles studied by ultraviolet–visible absorption and surface-enhanced Raman spectroscopy.Appl. Spectrosc. 60, 1386–1391.

  • Kumavat, S. D., Chaudhari,Y. S., Borole, P., Mishra, P., Shenghani, K., and Duvvuri, P. (2016). Degradation studies of curcumin. Int. J.Pharm.Rev.Res 3, 50–55.

  • Liu A, Lou H, Zhao L, Fan P (2006) Validated LC/MS/MS assay for curcumin and tetrahydrocurcumin in rat plasma and application to pharmacokinetic study of phospholipid complex of curcumin. J Pharm Biomed Anal 40(3):720–727.

  • Sun D, Zhuang X, Xiang X, Liu Y, Zhang S, Liu C, et al. A novel nanoparticle drug delivery system: the anti-inflammatory activity of curcumin is enhanced when encapsulated in exosomes. Mol Ther. 2010; 18: 1606-14.

  • He W, Zou C, Tian Z, Tan W, Shen W, Chen J, et al. Nasopharyngeal carcinoma treated with bevacizumab combined with paclitaxel liposome plus cisplatin: a case report and literature review. Onco Targets Ther. 2017; 10:67-72.2


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  • Efficacy and Safety of Liposomal Curcumin in the Management of Pain due to Osteoarthritis

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Authors

Yogesh Dound
Proprietor, Shreepad Shree Vallabh, SSV Phytopharmaceuticals, India
Akhil Chaudhari
Consultant Orthopedist, Vakratund Hospital Pvt Ltd, PathardiPhata, Nashik, India

Abstract


Aims and Background: The most prevalent chronic joint disease, which remains as one of the few chronic disorders of ageing is Osteoarthritis (OA). One of the predominant symptoms of OA is pain, with very little effective treatment and contributes to limitations in daily functioning. Therapy of pain due to OA includes pharmaceutical agents that need to be used in lowest possible dose to avoid adverse effects. Lot of advances have taken place in understanding the pathogenesis of OA, however, relief of pain have always remained an unfulfilled need. The anti-inflammatory property of Curcumin is mediated through the inhibition of induction of COX-2, LOX, iNOS and production of cytokines and tumor necrosis factor and activation of transcription factors like NF-κB, and AP-1. Its oral bioavailability is extremely poor.

Material and Methods: In the current study, Liposomal Curcumin was administered to 30 patients suffering from pain due to OA for 30 days. The therapeutic activity was assessed by reduction in the pain severity based on NPRS Score.

Results: By 30 days, there was statistically significant decrease in NPRS score. The pain reduced significantly along with decrease in weakness and fatigue. Improvement in daily physical functioning was shown by the WOMAC Arthritis Index. In 10 subjects the serum levels of Interleukin-6 (IL-6) and Tumour Necrosis Factor (TNF)α were examined at baseline and at 30th day. There was 76% improvement in TNF-α levels and 62% improvement in IL-6 levels in these subjects.

Conclusion: These results have shown for the first time in Indian population the efficacy of Liposomal Curcumin for OA Pain.


Keywords


Osteoarthritis, Pain, Liposomal Curcumin, Anti-Inflammatory.

References