One in seven Australians suffer from some form of arthritis, with 1 in 2 of these experiencing moderate to severe pain.¹ While there is an array of pharmaceutical options available for pain relief, some patients find these options come with undesirable side effects or they do not adequately manage their symptoms. These patients often seek natural alternatives to help reduce their exposure to these unwanted side effects or to complement their existing pain management plan. New alternatives and novel approaches are therefore a welcomed tool to help alleviate pain and inflammation, particularly in patients with musculoskeletal conditions.

Enter CurQfen^TM – The new kid on the block

One such alternative is CurQfen^TM, a unique combination of Curcuma longa (turmeric) and Trigonella foenum-graecum (fenugreek) galactomannans, a type of soluble fibre, containing 101 mg of curcuminoids and 133 mg of fenugreek, providing galactomannans to increase the absorption and bioavailability of the curcuminoids.

Turmeric polyphenols (curcumin, demethoxycurcumin and bisdemethoxycurcumin) are collectively referred to as curcuminoids, or curcumin.² This polyphenol complex has demonstrated antioxidant, anti-inflammatory, anti-proliferative, and immune-modulatory activity due to its ability to modulate a number of molecular targets that play a role in disease progression.^3,4,5 Regarding curcumin’s anti-inflammatory action, it has been shown to downregulate pro-inflammatory interleukins and cytokines, inhibit nuclear factor‑kappa B (NF-kB) activation and modulate inflammatory responses through the regulation of enzymes including inducible nitric oxide synthase (iNOS), cyclo-oxygenase-2 (COX-2), lipoxygenase, and xanthine oxidase.⁵ These qualities make curcumin an ideal candidate for a number of chronic disease conditions, including arthritis, pain and inflammatory musculoskeletal diseases.

However, curcumin has notoriously low oral bioavailability due to poor water solubility and hydrophobicity.⁶ Therefore, many curcumin preparations are now formulated to counteract this issue. In recent years, galactomannans contained within fenugreek have been shown to improve the bioavailability and absorption of herbs with low bioavailability, such as curcumin. This is achieved due to the ability of galactomannans to produce a stable hydrogel, allowing the oils and curcuminoids to be degraded over a longer period of time, prolonging the release of curcumin and improving the solubility and bioavailability of free curcumin, providing superior absorption of curcumin.^3,4

CurQfen^TM also has a strong safety profile, with relatively mild drug interactions alongside commonly prescribed analgesic and anti-inflammatory medications,^5,7 making it an ideal candidate for use in chronic pain and degenerative musculoskeletal conditions such as osteoarthritis.

CurQfen^TM hits the right targets

In a six-week study of patients with knee osteoarthritis (OA), CurQfen^TM was compared to a glucosamine-chondroitin combination. The participants were assessed for improvements in pain, joint flexibility, physical activity, and quality of life. Serum inflammatory markers were also monitored. Patients in the CurQfen^TM group experienced significant improvement in joint pain, stiffness and physical function in comparison to the glucosamine-chondroitin group. Further, changes in interleukin-1-beta (IL −1 β), IL-6, soluble vascular cell adhesion molecule-1 (sVCAM), and high-sensitivity C-reactive protein (hs-CRP) were measured, with noteworthy reductions seen in the CurQfen^TM group; indicating an anti-inflammatory effect. The number of subjects requiring analgesics (non-steroidal anti-inflammatory medications) during the study period was also tracked, with a considerable reduction in analgesic use in the CurQfen^TM group (31.43%) compared to the glucosamine-chondroitin group (52.35%) after the intervention.²

Similar results were also seen in a double-blind, randomised, controlled study comparing CurQfen^TM with glucosamine hydrochloride against a glucosamine-chondroitin combination in OA patients for 84 days. Using similar outcome measures, it was again demonstrated that the CurQfen^TM combination outshined the glucosamine-chondroitin intervention. Results included significant reductions in pain, stiffness and walking performance, which was almost doubled in the CurQfen^TM group in comparison to the glucosamine-chondroitin group by the end of the study period. Serum inflammatory markers were measured, with substantially higher reductions of IL-1β, IL-6, and sVCAM levels in the CurQfen^TM group.⁸

From little things, big things grow

CurQfen^TM is demonstrating solid clinical evidence to support its use in the management of such common inflammatory conditions such as mild to moderate osteoarthritis and musculoskeletal pain. Furthermore, its low toxicity and well-established safety alongside commonly prescribed medications, may help reduce pain and/or lower the amount of medication they consume to provide relief from their symptoms.

With a strong safety profile and enhanced bioavailability, the combination of curcumin and fenugreek as CurQfen^TM is gaining momentum as a novel strategy to consider when presented with patients experiencing chronic musculoskeletal pain and inflammation. The combination of these two seemingly small and common spices, has brought about big changes to treatment options for often hard-to-treat conditions, which goes to show that from little things, big things are possible.

References:

1 - Australian Institute of Health and Welfare. Australian Government. [Internet]. [Updated 2020 July 31. Cited 2021 October 20]. Available from: https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/arthritis/contents/arthritis

2 - Thomas JV, Smina TP, Khanna A, Kunnumakkara AB, Maliakel B, Mohanan R, Krishnakumar IM. Influence of a low‐dose supplementation of curcumagalactomannoside complex (CurQfen) in knee osteoarthritis: A randomized, open‐labeled, active‐controlled clinical trial. Phytotherapy Research. 2021 Mar;35(3):1443-55.

3 - Abhilash MB, Kumar D, Deepti A, Nair A, Greet V, An-Katrien V, Sivadasan SD, Maliakel B, PS BC, Madhavamenon KI. Enhanced absorption of curcuminoids and 3-Acetyl-11-keto-β-boswellic acid from fenugreek galactomannan hydrogel beadlets: A natural approach to the co-delivery of lipophilic phytonutrients. Journal of Functional Foods. 2021 Apr 1;79:104405.

4 - Tabanelli R, Brogi S, Calderone V. Improving Curcumin Bioavailability: Current Strategies and Future Perspectives. Pharmaceutics. 2021 Oct;13(10):1715.

5- Kocaadam B, Şanlier N. Curcumin, an active component of turmeric (Curcuma longa), and its effects on health. Critical reviews in food science and nutrition. 2017 Sep 2;57(13):2889-95.

6 - Kumar D, Jacob D, Subash PS, Maliakkal A, Johannah NM, Kuttan R, Maliakel B, Konda V, Krishnakumar IM. Enhanced bioavailability and relative distribution of free (unconjugated) curcuminoids following the oral administration of a food-grade formulation with fenugreek dietary fibre: a randomised double-blind crossover study. Journal of functional foods. 2016 Apr 1;22:578-87.

7 – D – Turmeric professional monograph. Natural Medicines Comprehensive Database [database on the Internet]. Stockton (A): Therapeutic Research Faculty; 1995-2020 [updated 2020 Dec 14; cited 2021 Nov 25]. Available from: https://naturalmedicines.therapeuticresearch.com subscription required to view

8 - C - Khanna A, Das SS, Smina TP, Thomas JV, Kunnumakkara AB, Maliakel B, Krishnakumar IM, Mohanan R. Curcumagalactomannoside/Glucosamine Combination Improved Joint Health Among Osteoarthritic Subjects as Compared to Chondroitin Sulfate/Glucosamine: Double-Blinded, Randomized Controlled Study. The Journal of Alternative and Complementary Medicine. 2020 Oct 1;26(10):945-55