Kurkuma- und Curcuminoid-Behandlung bei Gonarthrose

Zusammenfassung

Hintergrund Die Kurkumawurzel (Curcuma longa L.) wird traditionell in der ayurvedischen, indischen und chinesischen Medizin verwendet. Aufgrund ihrer entzündungshemmenden Eigenschaften gelten Curcuminoide, insbesondere Curcumin, als die wichtigsten Wirkstoffe der Kurkumawurzel und stehen im Mittelpunkt der Forschung zur Behandlung von Kniearthrose (medizinisch als Gonarthrose bezeichnet).

Methodik Um einen systematischen Überblick über den aktuellen Stand der Evidenz in klinischen Studien zur Wirksamkeit und Sicherheit der Kurkuma- und Curcuminoid-Behandlung bei Kniearthrose zu erhalten, wurde eine systematische Literaturrecherche in mehreren Datenbanken und eine Evidenzbewertung nach den AWMF-Leitlinien durchgeführt.

Ergebnisse Neun systematische Übersichtsarbeiten mit Meta-Analyse im Suchzeitraum 2012–2021 auf der Basis von insgesamt 16 randomisiert kontrollierten Studien (RCTs) bewerten die orale Mono- und Komplementärtherapie mit Kurkuma und Curcuminoiden bei Kniearthrose. Curcuminoid-haltige Präparate wurden einvernehmlich als sichere und klinisch wirksame Therapieoption zur Verbesserung von Schmerz und Funktion bei Kniearthrose im Vergleich zu Placebo (11 RCTs, n=850) oder ergänzend zur Schmerztherapie mit nicht steroidalen Antirheumatika (NSAR) (5 RCTs, n=747) bewertet. Es sind jedoch qualitativ hochwertige, groß angelegte RCTs erforderlich, um die therapeutische Wirksamkeit und Sicherheit für eine Langzeitbehandlung zu bestätigen. Zudem sind aktuell Kurkumaextrakte in Deutschland nicht als Arzneimittel erhältlich.

Schlussfolgerung In Anbetracht der begrenzten und hohen Nebenwirkungsraten der derzeitigen Schmerzbehandlungsoptionen kann eine orale Phytotherapie auf Kurkumabasis für die symptomatische Behandlung von Kniearthrose und als Ergänzung zur Schmerztherapie empfohlen werden.

Abstract

Background The turmeric rhizome (Curcuma longa L.) is traditionally used in Ayurvedic, Indian and Chinese medicine. Due to their anti-inflammatory properties, curcuminoids, especially curcumin, are considered as most important active ingredients of the turmeric root and are in the focus of research for the treatment of knee osteoarthritis (gonarthrosis).

Methods To provide a systematic overview of the current level of evidence in clinical trials about efficacy and safety of turmeric and curcuminoid treatment in knee osteoarthritis, a systematic literature search in several databases and evidence evaluation according to AWMF guidelines was performed.

Results Nine systematic reviews with meta-analysis within the period from 2012 to 2021 based on a total of 16 RCTs evaluate oral mono- and complementary turmeric and curcuminoid therapy in knee osteoarthritis. Curcuminoid-containing preparations were evaluated as a safe and clinically effective therapeutic option for improving pain and function in knee osteoarthritis compared to placebo (11 RCTs, n=850) or complementary to pain therapy with non-steroidal anti-inflammatory drugs (NSAIDs) (5 RCTs, n=747). However, high-quality large-scale RCTs are needed to confirm the therapeutic efficacy and safety for long-term treatment and until now turmeric extracts are not available as medicinal products in the EU.

Conclusion Considering the limited and high side effect rates of current pain treatment options, oral turmeric-based herbal therapy can be recommended in the symptomatic treatment of knee osteoarthritis and adjunction to pain therapy.

Schlüsselwörter

Gonarthrose - Osteoarthritis - Knie - Kniearthrose - Kurkuma - Curcumin - Phytotherapie - Leitlinien - Übersichtsarbeit

Key words

knee osteoarthritis - turmeric - curcuminoid - curcumin - phytotherapy - herbal medicine - guidelines - systematic review

Publication History

Article published online:
28 November 2022

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