Oral Curcumin in the treatment of moderate to severe psoriasis vulgaris: A prospective clinical trial

 

J Am Acad Dermatol. 2008; 58(4):625-31.

 

Psoriasis is a chronic inflammatory disease of skin and joints; associated with complications like decrease in Quality of life (QOL), multiple comorbidity, increased cardiovascular risk and mortality. Treatments for psoriasis are either time consuming or expensive and have risk of malignancies after long term use. This study was conducted to search for an effective, nontoxic therapy that is also convenient and affordable.
Curcumin, based on its physiological effects and positive anecdotal reports of its benefits for psoriasis, can be promising for treatment of psoriasis.

 

Objective:

To assess the safety and efficacy of oral Curcumin in the treatment of chronic psoriasis vulgaris.

 

Study Design:

A phase II, single-arm, single-dose, non-controlled, open-label, modified Simon’s two-stage clinical trial was planned with patients; having clinically stable chronic plaque psoriasis on 6% body surface area and thickness score of 2 on the Psoriasis Area Severity Index (PASI).

Patients were administered 4.5 g/day of Curcumin orally for 12 weeks followed by 4 week observation period after discontinuing the study drug. Patients were seen at baseline and regular intervals. End points included improvement in physicians global assessment score (PGA), PASI, QOL measured by Skindex 29 and safety end points throughout the study.

 

Results:

  • 4.5 g/day of oral Curcumin was well tolerated, therefore it is safe in patients with psoriasis. Also no study related severe adverse effect was noticed.
  • Efficacy of the study drug was low with an Intention-to treat response rate of 16.7% (95% confidence interval 2%, 48%).
  • Responders showed excellent responses of 83% and 88% improvement in PASI scores at week 12.

 

Conclusion:

Curcumin is well tolerated for the daily dose 4.5 g/day in patients with psoriasis. The overall response rate was low and could be because of placebo effect or natural disease remission. It is also possible that this low response may be because of low bioavailability of Curcumin. So a trial with higher dose/bioavailability enhancer must be considered for future trials.

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