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SYSTEMATIC REVIEW article

Front. Immunol.

Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders

Curcumin for the clinical treatment of rheumatoid arthritis: a systematic review and meta-analysis of placebo-controlled randomized clinical trials

Provisionally accepted
Yihua  FanYihua Fan1Zhiqiang  YiZhiqiang Yi2Shijie  MaoShijie Mao3Jialu  WenJialu Wen3Jiwei  ZhangJiwei Zhang3Qiang  ZhangQiang Zhang4Ruihan  LiuRuihan Liu4*
  • 1Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
  • 2Bazhong Hospital of Traditional Chinese Medicine, Bazhong, China
  • 3Chengdu University of Traditional Chinese Medicine, Chengdu, China
  • 4Chongqing Shapingba District People's Hospital Affiliated to Chongqing Universiy, Chongqing, China

The final, formatted version of the article will be published soon.

Background The efficacy and safety of curcumin in the treatment of rheumatoid arthritis (RA) remain controversial. We therefore conducted a meta-analysis to evaluate the efficacy and safety of curcumin in RA. Methods We searched PubMed, Embase, the Cochrane Library and Web of Science for relevant literature published up to July 30, 2025. The Cochrane risk of bias tool was used to assess bias in the included trials, and the Grade of Recommendations Assessment, Development and Evaluation (GRADE) framework was applied to evaluate the certainty of evidence. Meta-analyses were performed using Review Manager 5.3. Results Six studies involving 244 participants were included. The meta-analysis showed that curcumin significantly improved the following outcomes: American College of Rheumatology (ACR) 20 response (SMD = 4.35, 95%CI(2.22, 6.47), P < 0.0001; evidence certainty: very low), disease activity score(DAS-28) (SMD = -3.40, 95%CI(-5.29, -1.50), P = 0.0004; very low), erythrocyte sedimentation rate (ESR) level (SMD = -3.72, 95%CI(-5.26, -2.18), P < 0.00001; very low), C-reactive protein (CRP) level (SMD = -2.91, 95%CI(-4.42, -1.39), P = 0.0002; very low), visual analogue scale (VAS) score (SMD = -5.65, 95%CI(-6.95, -4.34), P < 0.00001; very low), tender joint count (TJC) (SMD = -2.84, 95%CI(-4.47, -1.22), P = 0.0006; very low), swollen joint count (SJC) (SMD = -4.11, 95%CI(-6.19, -2.03), P = 0.0001; very low), and rheumatoid factor (RF) level (SMD = -3.82, 95%CI(-4.62, -3.02), P <0.00001; low). Conclusion Current evidence suggests that curcumin has a significant therapeutic effect on RA. However, given the limitations of this meta-analysis, future multicenter, large-sample, placebo-controlled randomized trials are warranted to further verify its efficacy and safety.

Keywords: Curcumin, Meta-analysis, randomized controlled trials (as topic), Rheumatoid arthritis, Systematic review

Received: 16 Oct 2025; Accepted: 11 Dec 2025.

Copyright: © 2025 Fan, Yi, Mao, Wen, Zhang, Zhang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ruihan Liu

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