Akay's curcumin fenugreek formulation benefits osteoarthritis

The company details its research on the formulation's efficacy below

A randomised, active controlled study using Akay’s commercially available curcuminoid-fenugreek formulation often referred to as Curcumagalactomannosides (CGM; patented and registered as CurQfen) has indicated potential benefits in healthy osteoarthritis (OA) subjects.

The participants of the trial expressed significant improvement in the pain and physical activity having consumed the formulation at a dosage of 400 mg/day for 42 days, with notable changes by day 28.

The trial was done using a validated treadmill uphill walking protocol by simultaneous measurement of the joint pain, joint flexibility, improvements in physical function and quality of life using the tools of WOMAC, KPS and VAS scores in 84 subjects with class I-III OA.

Analysis of critical serum markers of inflammation and oxidative stress correlated the influence of CGM supplementation in the pathogenies of OA. There was 31.17, 32.93, 36.44, and 35% improvement in the pain, stiffness, physical function, and total WOMAC scores of the study subjects from baseline to the end of the study.

The supplementation of a low dosage CGM (400 mg) for a short-duration, designated a superior efficacy, even when compared to a high-dosage chondroitin sulphate

“We employed a complete protocol to monitor all the aspects of joint health which makes this study really unique among the other bioavailable curcumin studies so far. Though many studies have used WOMAC scores to measure the improvements, only a couple of studies have even detailed component scores including the influence on pain, stiffness, physical function. We have employed the secondary questionnaires, and analysed inflammations and compared with the standard Glucosamine/Chondrotin sulfate treatment, without concomitant administration of NSAIDs. Thus, the protocol could really evaluate the possible contribution of a free curcuminoids delivery form of curcumin at its lowest dosage,” says Chief Research officer at Akay, Dr. Krishnakumar.

Current trends in OA treatment

Recently, there has been an increase in clinicians suggesting dietary supplements like chondroitin sulphate, glucosamine, fish oil, and anti-inflammatory botanical extracts to relieve pain and improve physical activities among OA subjects. Turmeric/curcumin, being safe, stands out in this category of nutraceuticals.

All currently available studies on various curcumin supplements suggest 1 to 3 g/day of usage for four to six months. Akay’s low dosage, shot term study, shows what a curcumin supplement can provide, if it’s capable of delivering the bioactive forms of curcuminoids such as unconjugated free forms.

“The supplementation of a low dosage CGM (400 mg) for a short-duration, designated a superior efficacy, even when compared to a high-dosage chondroitin sulphate (415 mgx2)/day - glucosamine combination (500 mgx2)/day, in alleviating the pain and symptoms of OA subjects. CurQfen being prepared from turmeric and fenugreek using our patented water-based process of Fenumat technology, ensures the extreme safety and convenience for consumption in various pharma and food delivery forms” Emmanuel Nambusseril, Chief Marketing Officer at Akay natural Ingredients, the developers of CurQfen.

The overflow in curcumin industry

The poor oral bioavailability of curcumin has been established as the limitation in the translational of therapeutic efficacy of curcumin to clinics. Currently, the nutraceutical market is flooded with numerous curcumin formulations; claiming enhanced bioavailability. In the article, the researchers said: “Even though numerous curcumin products are available in the market claiming huge number of folds of bioavailability ranging from 10- to 285-folds, the expressed ‘number of folds’ represents the bioavailability of ‘conjugated metabolites of curcumin’ and not that of ‘free or unconjugated curcuminoids’. Curcumin glucuronides, the primary conjugated metabolites of curcumin, exhibits very weak therapeutic activity compared to the free curcuminoids.”

The paper has also reviewed the joint health clinical studies of various curcumin supplements so far and discussed their efficacy, dosage, durations, protocols of study and methods of efficacy measurements in detail to compare the pros and cons of each study.

How CurQfen acts in OA patients...

OA mainly develops due to the damage or break in the cartilage that acts as a cushion between the bones in a joint. Deterioration in the cartilage triggers inflammation causing swelling, pain, and stiffness leading to functional impairment and chronic disability. The imbalance of inflammatory signaling in the chondrocytes and synovial cells, with abnormal activation of cytokine cascade and overproduction of inflammatory mediators, is the characteristic of OA.

The analgesic effect and improvement in the physical function exhibited by CGM could primarily be attributed to its anti-inflammatory effects. “The potential anti-inflammatory activity of CGM is evident from the observed modulation in IL-1β, IL-6 sVCAM, and hs-CRP in the serum of OA patient’s after the study period. CGM could effectively reduce these biomarkers in the treated subjects indicating its potential to protect chondrocytes, thereby preventing cartilage degradation,” the paper’s authors said. These pro-inflammatory cytokines and proteins serve as the major biomarkers for synovitis and joint inflammation which has been associated with the pathogenesis of OA.

“The significant anti-inflammatory benefits of CGM at low dosage of 400 mg/day can be attributed to its free curcuminoids bioavailability. Curcuminoids when combined with galactomannans from fenugreek, form a noncovalent complex Curcumagalactomannoside (CGM) which can serve as novel oral delivery system of curcumin. The “free curcuminoid” bioavailability of CGM is 45.5-fold higher than the unformulated standard curcumin, with an extended elimination half-life of 3–4 hr. CGM has been identified as the only 100% natural commercially available formulation with significant ‘free curcuminoids’ bioavailability, better tissue distribution and blood–brain barrier permeability,” said Mr Nambusseril.

This curative properties of curcumin are enhanced by the complementary activity of fenugreek galactomannans. OA is more prevalent among obese individuals than people with healthy BMI, affecting their quality of life. CGM was also found to help overweight individuals attaining a healthy BMI. This observation is fascinating because bodyweight management is considered to be highly advantageous for the reduction of pain and other symptoms in obese arthritis patients. CGM consists of 60% w/w bioactive galactomannans (soluble fiber) and recent reports have shown that even 300 mg/day of this particular fiber fraction used in the formulation could significantly improve the physical working capacity at the fatigue threshold, peak oxygen consumption and time to exhaustion in young subjects who are not in regular exercise. Fenugreek dietary fiber has also been proven to have a significant prebiotic effect in regulating the intestinal microbiota leading to a healthier flora and exerts a positive influence on bodyweight, metabolic regulation, glycemic control, immune responses, and liver beta-oxidation. A low dose supplementation of curcuminoid-fenugreek complex seems more promising in osteoarthritis patients than the historical curcumin/turmeric ingredients