The Effect of Oral Consumption of Echinops Spp. and Curcumin on the Outcomes of Idiopathic Knee Osteoarthritis: A Three-Blind Randomized Clinical Trial

Abstract

Abstract Introduction: Osteoarthritis is one of the most important common debilitating condition and causes decrease in the quality of life. Due to the side effects of common treatments (corticosteroids and non-steroidal anti-inflammatory drugs), the development of new treatments is necessary. The purpose of this study was to investigate the effect of using dietary Echinops-SPP and curcumin on the Consequences of idiopathic knee osteoarthritis. Materials and methods: In this randomized control trial, 96 patients with knee osteoarthritis who met the inclusion criteria were divided into three groups using the block randomization method in the form of blocks of 3 and they were divided with an allocation ratio of 1:1:1 without classification by Random org web site. The person who performed the random assignment, after determining the participants group by randomization method, provided the patient with a sealed envelope in which the group number of the participant was specified to receive one of the three types of oral capsuls (echinops, curcumin and placebo) which were prepared in the same shape and size depending on the designated group. Random allocation by the supervisor and drug presentation by the researcher was done with full confidentiality, so the participat, the researcher and the outcome evaluator (rheumatologist) were unaware of the group assigned. One intervention group received Echinops-SPP, the other received curcumin capsules tand he control group received placebo form with 750 mg twice a day for 12 weeks. Data collection was done by using demographic characteristics and arthritis index questionnaire (WOMAC) to measure the consequences of knee osteoarthritis. Goniometry was done to measure range of motion of joint. SPSS software version 25 was used for data analysis. T-test was used to compare the outcomes of each intervention group with the control group, and U-Mann-Whitney test was used in case of non-parametric. Due to the multi-group nature of the study, ANOVA test was used to find the difference between the meanof the groups and LSD and Tukey tests were used to find the difference between the groups. In case of heterogeneity of variances, Brown-Forsyth and Kruskal-Wallis tests were used. Analysis of variance was used in repeated measurements to check the difference of means in time intervals. Findings: In this study, all three groups of curcumin, Echinops-SPP, and placebo, were randomly assigned and blinded. There was no significant difference between the three groups in terms of demographic caracteristic and WOMAC information before the intervention. The mean score of the WOMC tool did not have a significant difference. After the intervention, these results improved in both the curcumin and Echinops-SPP receiving group, and respectively, the Echinops-SPP receiving group was better than curcumin and the curcumin receiving group was better than the control group, respectively. There was a statistically significant difference between the outcomes of both intervention groups and the control group (p<0.05) And after the intervention, these results improved in both groups receiving curcumin (100.18 ± 12.28) and those receiving Echinops SPP (74.96 ± 7.23) and respectively in the receiving group Echinops SPP is better than curcumin and in the group receiving curcumin better than the control group, (74.96 ± 7.23) echinops > (100.18 ± 12.28) curcumin > (75.81 ± 9.8) placebo Was. Also, the NNT test showed that 1 out of every 1/5 patients in the curcumin group and 1 out of every 1/8 patients in the Echinops-SPP group responded to the treatment. Conclusion: The results showed that although the daily consumption of 750 mg of both Echinops-SPP and curcumin capsules for 4 and 12 weeks is effective in reducing pain in patients with knee osteoarthritis, the effect of Echinops-SPP capsules is slightly better than curcumin capsules. According to the findings of this study, it can be concluded that the use of herbal supplements such as curcumin and Echinops-SPP can be effective in reducing knee joint pain in patients with knee osteoarthritis.