Effect of turmeric products on knee osteoarthritis: a systematic review and network meta-analysis

Abstract Background Turmeric has traditionally been used to treat various inflammatory conditions, including knee osteoarthritis (OA). There are multiple turmeric preparations available. However, the comparative effectiveness of these products remains unknown. This study aimed to assess the comparat...

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Main Authors: Han Su Wai, Thanika Pathomwichaiwat, Thanarat Suansanae, Surakit Nathisuwan, Wipharak Rattanavipanon
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Complementary Medicine and Therapies
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Online Access:https://doi.org/10.1186/s12906-025-05045-z
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author Han Su Wai
Thanika Pathomwichaiwat
Thanarat Suansanae
Surakit Nathisuwan
Wipharak Rattanavipanon
author_facet Han Su Wai
Thanika Pathomwichaiwat
Thanarat Suansanae
Surakit Nathisuwan
Wipharak Rattanavipanon
author_sort Han Su Wai
collection DOAJ
description Abstract Background Turmeric has traditionally been used to treat various inflammatory conditions, including knee osteoarthritis (OA). There are multiple turmeric preparations available. However, the comparative effectiveness of these products remains unknown. This study aimed to assess the comparative effectiveness of turmeric products for knee OA outcomes by conducting a systematic review and network meta-analysis of randomized, controlled trials (RCTs). Methods PubMed, EMBASE, SCOPUS, and ClinicalTrials.gov databases were searched up to August 2024, identifying RCTs that compared turmeric preparations and/or active comparators versus placebo. The primary outcome measured pain reduction, using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), while secondary outcomes evaluated pain using other tools. Mean differences (MDs) were pooled using a random-effects model, and the concept of minimum clinically important difference (MCID) was considered. Results Seventeen studies were included. All turmeric preparations significantly reduced WOMAC pain. The mean differences (MD, 95% CI) for WOMAC pain reduction were as follows: − 4.01 (–6.22, − 1.80) for conventional curcuminoid preparations (CT) plus active drug comparators (AC, defined as NSAIDs and acetaminophen), − 3.33 (–5.26, − 1.39) for AC, − 3.17 (–5.50, − 0.83) for CT, and − 2.47 (–3.27, − 1.67) for bioavailability-enhanced curcuminoid preparations (BE). The BE preparation also demonstrated a 30% reduction in WOMAC pain compared to placebo, reaching the MCID threshold. The BE + AC combination led to a 70% reduction in VAS pain compared to AC alone. Conclusions All turmeric preparations appear to be effective in reducing knee OA pain when used as monotherapy compared to placebo. However, the certainty of evidence remains low, indicating a need for further research. PROSPERO registration number CRD42023464749. Clinical trial number not applicable.
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spelling doaj-art-52488a3290df4ca2abe45596cfc81ef72025-08-20T03:42:40ZengBMCBMC Complementary Medicine and Therapies2662-76712025-07-0125111110.1186/s12906-025-05045-zEffect of turmeric products on knee osteoarthritis: a systematic review and network meta-analysisHan Su Wai0Thanika Pathomwichaiwat1Thanarat Suansanae2Surakit Nathisuwan3Wipharak Rattanavipanon4Clinical Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol UniversityDepartment of Pharmaceutical Botany, Faculty of Pharmacy, Mahidol UniversityClinical Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol UniversityClinical Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol UniversityClinical Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol UniversityAbstract Background Turmeric has traditionally been used to treat various inflammatory conditions, including knee osteoarthritis (OA). There are multiple turmeric preparations available. However, the comparative effectiveness of these products remains unknown. This study aimed to assess the comparative effectiveness of turmeric products for knee OA outcomes by conducting a systematic review and network meta-analysis of randomized, controlled trials (RCTs). Methods PubMed, EMBASE, SCOPUS, and ClinicalTrials.gov databases were searched up to August 2024, identifying RCTs that compared turmeric preparations and/or active comparators versus placebo. The primary outcome measured pain reduction, using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), while secondary outcomes evaluated pain using other tools. Mean differences (MDs) were pooled using a random-effects model, and the concept of minimum clinically important difference (MCID) was considered. Results Seventeen studies were included. All turmeric preparations significantly reduced WOMAC pain. The mean differences (MD, 95% CI) for WOMAC pain reduction were as follows: − 4.01 (–6.22, − 1.80) for conventional curcuminoid preparations (CT) plus active drug comparators (AC, defined as NSAIDs and acetaminophen), − 3.33 (–5.26, − 1.39) for AC, − 3.17 (–5.50, − 0.83) for CT, and − 2.47 (–3.27, − 1.67) for bioavailability-enhanced curcuminoid preparations (BE). The BE preparation also demonstrated a 30% reduction in WOMAC pain compared to placebo, reaching the MCID threshold. The BE + AC combination led to a 70% reduction in VAS pain compared to AC alone. Conclusions All turmeric preparations appear to be effective in reducing knee OA pain when used as monotherapy compared to placebo. However, the certainty of evidence remains low, indicating a need for further research. PROSPERO registration number CRD42023464749. Clinical trial number not applicable.https://doi.org/10.1186/s12906-025-05045-zTurmericKnee osteoarthritisSystematic reviewNetwork meta-analysisCurcuminoid
spellingShingle Han Su Wai
Thanika Pathomwichaiwat
Thanarat Suansanae
Surakit Nathisuwan
Wipharak Rattanavipanon
Effect of turmeric products on knee osteoarthritis: a systematic review and network meta-analysis
BMC Complementary Medicine and Therapies
Turmeric
Knee osteoarthritis
Systematic review
Network meta-analysis
Curcuminoid
title Effect of turmeric products on knee osteoarthritis: a systematic review and network meta-analysis
title_full Effect of turmeric products on knee osteoarthritis: a systematic review and network meta-analysis
title_fullStr Effect of turmeric products on knee osteoarthritis: a systematic review and network meta-analysis
title_full_unstemmed Effect of turmeric products on knee osteoarthritis: a systematic review and network meta-analysis
title_short Effect of turmeric products on knee osteoarthritis: a systematic review and network meta-analysis
title_sort effect of turmeric products on knee osteoarthritis a systematic review and network meta analysis
topic Turmeric
Knee osteoarthritis
Systematic review
Network meta-analysis
Curcuminoid
url https://doi.org/10.1186/s12906-025-05045-z
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