Herbal Combo Shows Promise in Active Ulcerative Colitis

June 15, 2023 Editorial Staff 538 Views

TOPLINE:

A combination of the herbal extracts curcumin and Qing Dai can induce remission in a significant proportion of patients with active ulcerative colitis (UC), according to the results of a phase 2 placebo-controlled trial.

METHODOLOGY:

The study included 42 adults with active UC who were randomly assigned (2:1) to an enteric-coated pill containing 3 g of curcumin and Qing Dai (CurQD) or placebo for 8 weeks.
The coprimary outcome was a clinical response (reduction in Simple Clinical Colitis Activity Index ≥ 3 points) and an objective response (Mayo endoscopic sub-score improvement ≥ 1 or 50% fecal calprotectin reduction).
Responding patients continued either maintenance curcumin alone or placebo for an additional 8 weeks.
Aryl-hydrocarbon receptor (AhR) activation was assessed by Cyp1A1 mucosal expression.

TAKEAWAY:

Of the CurQD patients, 43% met the coprimary endpoint of a significant reduction in disease activity and objective evidence of response, vs 8% of the placebo patients (P = .033).
A clinical response was observed in 86% of the CurQD patients vs 31% of the placebo patients (P < .001) and clinical remission in 50% and 8%, respectively (P = .01).
Endoscopic improvement was observed in 75% of the CurQD patients vs 20% of the placebo patients (P = .036). The responses were maintained at 16 weeks with maintenance curcumin alone.
CurQD uniquely activated the AhR-pathway implicated as a mediator of inflammatory bowel disease (IBD).

IN PRACTICE:

“More studies are warranted to investigate this nutraceutical treatment strategy in UC and to interrogate AhR pathway as a possible novel therapeutic target in IBD,” the authors write.

STUDY DETAILS:

The study was led by Shomron Ben-Horin, MD, of Sheba Medical Center in Tel Aviv, Israel. It was published online June 9 in Clinical Gastroenterology & Hepatology. The study had no commercial funding.