Comparison of oral Nano-Curcumin with oral prednisolone on oral lichen planus: a randomized double-blinded clinical trial.

The short version

This double-blinded randomised trial with 57 adults who have oral lichen planus (OLP) explored whether nano-curcumin, a highly absorbable form of the turmeric compound curcumin, could ease the condition as effectively as the steroid prednisolone. OLP is an autoimmune condition in which T cells attack the lining of the mouth, producing white streaks, erosions, burning and pain; steroids are the standard treatment but cause side effects when used long term. Curcumin has anti-inflammatory and antioxidant properties, but ordinary curcumin is poorly absorbed, so the researchers tested a nano-sized version taken by mouth. At an oral medicine department in Iran, 60 patients with erosive or atrophic OLP were randomly assigned to take either one 80 mg nano-curcumin capsule or one 10 mg prednisolone capsule each morning after breakfast for 4 weeks. An examiner who did not know the groups measured lesion size with calipers and a lesion-grading scale and asked patients to rate pain and burning from 0 to 10 at the start and at weeks 1, 2 and 4. Fifty-seven patients were analysed. Both treatments helped. Pain fell from 4.65 to 2.69 with nano-curcumin and from 4.89 to 2.33 with prednisolone (p < 0.001 over time), and lesions shrank from 3.83 to 2.34 versus 3.61 to 1.83 (p < 0.001 over time). The two groups did not differ significantly at any visit (pain p = 0.428, lesion size p = 0.568), although prednisolone was ahead on lesion size at week 4 by a margin that did not reach significance (p = 0.117). Curcumin's pain relief became significant from week 2, prednisolone's from week 1. The trial had no placebo arm, lasted only 4 weeks, and followed no one after treatment, so recurrence could not be measured. The authors suggest nano-curcumin may be an option for people who cannot take corticosteroids and that its dose may matter more than treatment length, and they call for longer studies.

Key findings

• In this double-blind trial, 57 people with erosive or atrophic oral lichen planus (an autoimmune condition that causes painful sores and white patches in the mouth) took either 80 mg of nano-curcumin, a highly absorbable form of turmeric's active compound, or 10 mg of the steroid prednisolone daily for 4 weeks.
• Pain scores fell from 4.65 to 2.69 (out of 10) with nano-curcumin and from 4.89 to 2.33 with prednisolone, and lesion size fell from 3.83 to 2.34 versus 3.61 to 1.83.
• The two treatments did not differ significantly at any visit (pain p = 0.428, lesion size p = 0.568), although prednisolone was numerically ahead on lesion size at week 4 (p = 0.117).
• There was no placebo group and no follow-up after the 4 weeks, so the trial cannot show how much of the improvement was due to the treatments or whether lesions returned.
• The authors suggest nano-curcumin may suit people who cannot take corticosteroids and call for longer studies.

Common questions