Oral curcumin in elective abdominal aortic aneurysm repair: a multicentre randomized controlled trial.

CMAJ. 2018 Oct 29;190(43):E1273-E1280. doi: 10.1503/cmaj.180510. Garg AX1, Devereaux PJ2, Hill A2, Sood M2, Aggarwal B2, Dubois L2, Hiremath S2, Guzman R2, Iyer V2, James M2, McArthur E2, Moist L2, Ouellet G2, Parikh CR2, Schumann V2, Sharan S2, Thiessen-Philbrook H2, Tobe S2, Wald R2, Walsh M2, Weir M2, Pannu N2; Curcumin AAA AKI Investigators. Author information 1 Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta. amit.garg@lhsc.on.ca. 2 Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta. Abstract BACKGROUND: Curcumin, a popular herbal supplement from the plant turmeric, has prevented ischemic reperfusion and toxin-induced injury in many animal studies and a single-centre randomized human trial. We sought to test whether perioperative oral curcumin (compared with placebo) affects the inflammatory response and risk of postrepair complications after elective abdominal aortic aneurysm repair in humans. METHODS: We conducted a parallel-group, randomized, placebo-controlled trial of patients from 10 hospitals in Canada who were scheduled to undergo elective repair of an unruptured abdominal aortic aneurysm (November 2011 to November 2014). Patients in the treatment group received perioperative oral curcumin (2000-mg doses 8 times over 4 d). Patients, health care providers and local research staff were unaware of the treatment assignment. The primary outcomes were median concentrations of 4 bio markers indicating injury and inflammation (postoperative urine interleukin-18 and perioperative rise in serum creatinine, plasma N-terminal pro-B-type natriuretic peptide and plasma high-sensitivity C-reactive protein). RESULTS: Baseline characteristics were similar in the 2 groups (606 patients overall; median age 76 yr). More than 85% of patients in each group took more than 80% of their scheduled capsules. Neither curcumin nor placebo significantly affected any of the 4 biomarkers (p > 0.05 for all comparisons). Regarding the secondary outcomes, there was a higher risk of acute kidney injury with curcumin than with placebo (17% v. 10%, p = 0.01), but no between-group difference in the median length of hospital stay (5 v. 5 days, p > 0.9) or the risk of clinical events (9% v. 9%, p = 0.9). INTERPRETATION: Curcumin had no beneficial effects when used in elective abdominal aortic aneurysm repair. These findings emphasize the importance of testing turmeric and curcumin before espousing their health benefits, as is currently done in the popular media. TRIAL REGISTRATION: ClinicalTrials.gov, no. NCT01225094. © 2018 Joule Inc. or its licensors. PMID: 30373740 PMCID: PMC6205831 DOI: 10.1503/cmaj.180510 Free PMC Article