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Cruz-Correa M, Hylind LM, Marrero JH, Zahurak ML, Murray-Stewart T, Casero RA, Montgomery EA, Iacobuzio-Donahue C, Brosens LA, Offerhaus GJ, Umar A, Rodriguez LM, Giardiello FM. Efficacy and Safety of Curcumin in Treatment of Intestinal Adenomas in Patients With Familial Adenomatous Polyposis. Gastroenterology 2018; 155:668-673. [PMID: 29802852 PMCID: PMC6120769 DOI: 10.1053/j.gastro.2018.05.031] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/08/2018] [Accepted: 05/16/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Familial adenomatous polyposis is an autosomal dominant disorder characterized by the development of hundreds of colorectal adenomas and eventually colorectal cancer. Oral administration of the spice curcumin has been followed by regression of polyps in patients with this disorder. We performed a double-blinded randomized trial to determine the safety and efficacy of curcumin in patients with familial adenomatous polyposis. METHODS This study included 44 patients with familial adenomatous polyposis (18-85 years old) who had not undergone colectomy or had undergone colectomy with ileorectal anastomosis or ileal anal pouches, had at least 5 intestinal adenomatous polyps, and had enrolled in Puerto Rico or the United States from September 2011 through November 2016. Patients were randomly assigned (1:1) to groups given 100% pure curcumin (1,500 mg orally, twice per day) or identical-appearing placebo capsules for 12 months. The number and size of lower gastrointestinal tract polyps were evaluated every 4 months for 1 year. The primary outcome was the number of polyps in the curcumin and placebo groups at 12 months or at the time of withdrawal from the study according to the intention-to-treat principle. RESULTS After 1 year of treatment, the average rate of compliance was 83% in the curcumin group and 91% in the placebo group. After 12 weeks, there was no significant difference in the mean number of polyps between the placebo group (18.6; 95% CI, 9.3-27.8) and the curcumin group (22.6; 95% CI, 12.1-33.1; P = .58). We found no significant difference in mean polyp size between the curcumin group (2.3 mm; 95% CI, 1.8-2.8) and the placebo group (2.1 mm; 95% CI, 1.5-2.7; P = .76). Adverse events were few, with no significant differences between groups. CONCLUSIONS In a double-blinded randomized trial of patients with familial adenomatous polyposis, we found no difference in the mean number or size of lower intestinal tract adenomas between patients given curcumin 3,000 mg/day and those given placebo for 12 weeks. Clinicaltrials.gov ID NCT00641147.
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Affiliation(s)
- Marcia Cruz-Correa
- Department of Medicine and Biochemistry, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, Puerto Rico; University of Puerto Rico Comprehensive Cancer Center, University of Puerto Rico, San Juan, Puerto Rico
| | - Linda M Hylind
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jessica Hernandez Marrero
- Department of Medicine and Biochemistry, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, Puerto Rico; University of Puerto Rico Comprehensive Cancer Center, University of Puerto Rico, San Juan, Puerto Rico
| | - Marianna L Zahurak
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Tracy Murray-Stewart
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert A Casero
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Elizabeth A Montgomery
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Christine Iacobuzio-Donahue
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Pathology, Memorial Sloan Kettering, New York, New York
| | | | - G Johan Offerhaus
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Utrecht Medical Center, Utrecht, Netherlands
| | - Asad Umar
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Luz M Rodriguez
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Francis M Giardiello
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
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