Turmeric supplement more effective than placebo for osteoarthritis knee pain

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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.


1. Turmeric supplement more effective than placebo for osteoarthritis knee pain
Abstract: https://www.acpjournals.org/doi/10.7326/M20-0990
URL goes live when the embargo lifts

An extract of Curcuma longa (CL), commonly known as turmeric, was found to be more effective than placebo for reducing knee pain in patients with knee osteoarthritis. However, CL did not affect structural aspects of knee osteoarthritis, such as swelling or cartilage composition assessed using MRI. Findings from a randomized, double-blind, placebo-controlled trial are published in Annals of Internal Medicine.

Despite its large disease burden, no approved disease-modifying drugs currently are available to treat osteoarthritis. Common treatments, such as acetaminophen and nonsteroidal anti-inflammatory drugs have only mild to moderate effects and are associated with adverse events. As such, an urgent need exists for safer and more effective drugs to treat osteoarthritis.

Researchers from the University of Tasmania, Australia randomly assigned 70 participants with symptomatic knee osteoarthritis and ultrasound evidence of effusion (swelling inside the knee joint) to receive either 2 capsules per day of CL (n = 36) or matched placebo (n = 34) for 12 weeks to determine the efficacy CL for reducing knee symptoms and joint swelling. Changes in pain and knee effusion-synovitis volume were assessed by standardized questionnaire and MRI, respectively, over 12 weeks. The researchers also looked for changes in cartilage composition, pain medication usage, quality of life, physical performance measures, and adverse events. After 12 weeks, they found that patients taking the turmeric supplements reported less pain than those in the placebo group with no adverse events. Besides, participants in the turmeric group consumed fewer pain medications compared to the participants in the placebo group. There was no difference in the structural aspects of knee osteoarthritis between the groups. Due to the modest effect of the turmeric extracts on knee pain, small sample size of the study, short-duration of follow-up and the single research center, the researchers suggest that multicenter trials with larger sample sizes and long duration of follow-up are needed to assess the clinical significance of their findings.

Media contacts: For an embargoed PDF, please contact Lauren Evans at laevans@acponline.org. To reach the principal investigator, Dr. Benny Antony, please contact Angela Wilson at angela.wilson@utas.edu.au.


2. Internists Call for Increased Competition in Prescription Drug Market to Help Mitigate Rising Costs
Abstract: https://www.acpjournals.org/doi/10.7326/M19-3773
URL goes live when the embargo lifts

The American College of Physicians (ACP) released a new policy paper focused on increasing competition in the marketplace and addressing anticompetitive behaviors to combat the rising costs of prescription drugs. The new paper is the third installment of a series published in Annals of Internal Medicine.

ACP specifically offered the following recommendations:

* ACP supports legislative reforms to the Orphan Drug Act (ODA) that realign incentives offered through the law to support increased innovation in rare disease drug development.

* ACP supports reducing the period of data and market exclusivity for biologic drugs from 12 years to 7 years. ACP also supports removing additional barriers to biosimilar market entry, such as modifications to the current patent system that would reduce excessive patenting on brand-name and biologic drugs.

* ACP opposes anticompetitive pay-for-delay arrangements that curtail access to lower-cost alternative drugs. ACP believes applicable federal agencies should be empowered through guidance, congressional action, or additional resource support to address anticompetitive behaviors and gaming.

* ACP supports elimination of tax deductions for direct-to-consumer product claim advertisements.

The new paper follows the previously published papers that both made recommendations about the role of Pharmacy Benefit Managers (PBMs) and how to address the issue of prescription drug costs within public health plans. Together the three papers expand on ACP’s comprehensive policy on drug pricing that began with the 2016 paper, Stemming the Escalating Cost of Prescription Drugs.

Media contacts: For an embargoed PDF, please contact Lauren Evans at laevans@acponline.org. To speak with someone from ACP, please contact Taneishia Bundy at tbundy@acponline.org.


3. Improved glycemic control reduced symptoms in patients with polymyalgia rheumatica and diabetes
Abstract: https://www.acpjournals.org/doi/10.7326/L20-0916
URL goes live when the embargo lifts

Symptoms and laboratory measures of polymyalgia rheumatica activity in 3 patients improved rapidly without glucocorticoid administration or an increase in glucocorticoid dosage after they achieved good glycemic control. According to the researchers, these findings were both unexpected and remarkable, and could not likely be a coincidence. A case report is published in Annals of Internal Medicine.

Polymyalgia rheumatica, a chronic inflammatory condition affecting elderly persons, is characterized by severe pain and stiffness, occurring mostly in the shoulders, upper arms, and pelvis area. The condition is usually treated with glucocorticoid therapy, which takes years to work and is associated with adverse events such as diabetes, hypertension, and osteoporosis.

Researchers from the Jikei University School of Medicine, Tokyo, Japan describe 3 cases where patients with bothersome symptoms of polymyalgia rheumatica did not achieve pain or stiffness relief after months of nonsteroidal anti-inflammatory drugs (NSAIDs) or steroid treatment. The patients also had type 2 diabetes and poorly controlled glucose levels. Before treating any of the patients with a glucocorticoid, the physicians adjusted the patients’ diabetes regimens. To their surprise, the patients’ symptoms of rheumatica improved rapidly and dramatically enough that no further treatment was needed. According to the authors, these findings suggest that a randomized controlled trial is warranted.

Media contacts: For an embargoed PDF, please contact Lauren Evans at laevans@acponline.org. To reach the corresponding author, Ken Yoshida, MD, PhD, please email k.yoshida@jikei.ac.jp.

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