Efficacy of curcumin and Boswellia for knee osteoarthritis: Systematic review and meta-analysis.
Efficacy of curcumin and Boswellia for knee osteoarthritis: Systematic review and meta-analysis.
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DOI：
10.1016/j.semarthrit.2018.03.001
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发表时间：
2018-12
影响因子：
5
通讯作者：
Wang C
中科院分区：
文献类型：
--
作者：
Bannuru RR;Osani MC;Al-Eid F;Wang C
通常处方的膝骨性关节炎(OA)治疗的安全性不佳，导致临床医生和患者寻求更安全的替代方案。研究表明，姜黄素和博斯韦利制剂可以缓和与症状恶化和疾病进展有关的关键炎症途径。我们进行了一项系统的综述和荟萃分析，以评估这些治疗方法与安慰剂或非甾体抗炎药治疗膝骨性关节炎的有效性和安全性。我们检索了Medline、EMBASE、Google Scholar、Web of Science和Cochrane数据库，从最初到2018年2月21日。我们还手工搜索了参考文献列表，并回顾了会议记录。我们纳入了随机临床试验(RCT)，比较姜黄素或博斯韦利制剂与安慰剂或非甾体抗炎药治疗膝骨性关节炎的疗效。我们计算了所有相关结果的标准化均数差(SMD)或风险比(RR)。Meta分析采用随机效应模型。异质性用I2统计量进行评估。11个随机对照试验(N=1,009)符合分析条件。总体来说，研究质量较低，大多数随机对照试验的参与者不到100人。在止痛和功能改善方面，姜黄素和博斯韦利亚制剂在统计学上都比安慰剂有效得多。姜黄素类药物或博斯韦利与安慰剂在安全结果上没有显著差异。与非类固醇抗炎药相比，姜黄素类药物在疗效结果上没有统计学上的显著差异；接受姜黄素类药物的患者发生胃肠道不良事件的可能性显著减少。没有随机对照试验将Boswell与批准的非甾体抗炎药进行比较。我们的研究结果表明，姜黄素和博斯韦利亚制剂可能是膝骨性关节炎治疗方案中有价值的补充，因为它可以缓解症状，同时降低安全风险。目前的证据在大小或质量上不足以提出任何有意义的临床实践建议。有必要通过大规模、高质量的随机对照试验进一步研究这些产品与其他骨性关节炎治疗方法的协同效应。
The unfavorable safety profiles of commonly prescribed knee osteoarthritis (OA) treatments have led clinicians and patients to seek safer alternatives. Research has suggested that curcuminoid and boswellia formulations could moderate key inflammatory pathways that are associated with worsening symptoms and disease progression. We conducted a systematic review and meta-analysis to assess the efficacy and safety of these treatments vs. placebo or NSAIDs for knee OA. We searched Medline, EMBASE, Google Scholar, Web of Science and the Cochrane database from inception to February 21, 2018. We also hand searched reference lists and reviewed conference proceedings. We included randomized clinical trials (RCTs) comparing curcuminoid or boswellia formulations with placebo or NSAIDs for knee OA. We calculated standardized mean differences (SMD) or risk ratios (RR) for all relevant outcomes. Meta-analyses were conducted using random effects models. Heterogeneity was assessed using the I2 statistic. Eleven RCTs (N= 1,009) were eligible for analysis. Study quality was low overall, and most included RCTs were conducted on fewer than 100 participants. Both curcuminoid and boswellia formulations were statistically significantly more effective than placebo for pain relief and functional improvement. There were no significant differences between curcuminoids or boswellia and placebo in safety outcomes. Curcuminoids showed no statistically significant differences in efficacy outcomes compared to NSAIDs; patients receiving curcuminoids were significantly less likely to experience gastrointestinal adverse events. No RCTs compared boswellia against approved NSAIDs. The results of our study suggest that curcuminoid and boswellia formulations could be a valuable addition to the knee OA treatment regimens by relieving symptoms while reducing safety risks. The current body of evidence is not adequate in size or quality to make any meaningful clinical practice recommendations. Further research through large, high quality RCTs probably investigating the synergistic effect of these products with other OA treatments is warranted.
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影响因子：
8.4
作者：
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通讯作者：
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影响因子：
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作者：
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作者：
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通讯作者：
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