Patients with active ulcerative colitis may be able to reduce symptoms and achieve remission by taking a plant-based treatment combining the herbal compounds curcumin and qingdai, preliminary results from a new study suggest.

Curcumin is the main compound in the spice turmeric, and has been used for medicinal purposes for centuries. Qingdai, also called Indigo naturalis, can be extracted from several different plants and also has a long history of medicinal use. While some previous research suggests these substances may be beneficial for ulcerative colitis patients, results have been mixed, some safety issues have been raised, and most of the studies have been too small and too brief to draw broad conclusions.

The new study explored the safety and effectiveness of these compounds with three separate tests. In the first part of the study, 10 ulcerative colitis patients took a combination of curcumin and qingdai for four weeks. Seven people had a clinical response — meaning their symptoms became less frequent or severe — and three people achieved remission, according to preliminary study findings presented at the Crohn’s and Colitis Congress 2023 in Denver.

For the second part of the trial, 42 ulcerative colitis patients were randomly assigned to take either a placebo or a combination of curcumin and qingdai for eight weeks. Eighty-six percent of patients on the herbal treatments had a clinical response, compared with 31 percent on placebo.

Patients who responded to the herbal treatment then received an additional eight weeks of curcumin alone. Nearly all of them had a sustained clinical response, and 80 percent achieved remission.

“These results are clearly exciting,” says Byron Vaughn, MD, an associate professor of medicine and co-director of the inflammatory bowel disease program at the University of Minnesota in Minneapolis.

“It will be extremely important to understand the reproducibility of this effect in the future and the effect in various subpopulations of IBD,” adds Dr. Vaughn, who wasn’t involved in the new study.

The safety picture for curcumin and qingdai wasn’t clear from the preliminary study findings, however. Researchers reported that the proportion of patients experiencing side effects was comparable for both the treatment and the placebo groups in the study, but they didn’t provide any details on how many patients were impacted or what issues they had. The findings also weren’t published in a medical journal or independently verified.

Beyond this, the exact amount of curcumin and qingdai used in the study wasn’t specified, making it difficult to determine what mix of these compounds might work best for patients, says Sunanda Kane, MD, a professor and IBD specialist at the Mayo Clinic in Rochester, Minnesota, who wasn’t involved in the new study.

“While both of these agents are available over the internet, the combination of the two is not,” Dr. Kane says. “We do not know the exact amounts of each agent in the formulation enough to say that these results could be replicated.”

Even so, the findings from the new study add to an emerging body of evidence suggesting that curcumin and qingdai are worth testing further as potential treatments for ulcerative colitis, says Vaughn.

Consult With an IBD Specialist Before Taking Herbal Remedies for UC

One six-month clinical trial of 82 ulcerative colitis patients in remission gave patients either curcumin or a placebo for six months. All of the patients were also taking sulfasalazine or mesalamine — drugs often prescribed for ulcerative colitis. About 95 percent of patients on curcumin maintained remission after six months compared with about 79 percent on placebo.

Another trial focused on 50 patients with active ulcerative colitis taking mesalamine. They were randomly assigned to take either curcumin or a placebo for one month. Fifty-four percent of patients on curcumin achieved remission, but none on the placebo did.

A small trial of qingdai in 86 patients with active ulcerative colitis found up to 81 percent had a clinical response based on reduced symptom severity after two months on the highest tested dose of qingdai, compared with 14 percent on placebo. And 38 percent of patients on the highest qingdai dose achieved clinical remission, compared with less than 5 percent on placebo. But this study raised safety concerns for people taking qingdai: One patient developed pulmonary hypertension and 10 people had mild liver dysfunction.

Liver issues were also seen in 10 percent of patients in another small study of 20 people with active ulcerative colitis taking qingdai for two months. This study did find that 72 percent of patients had a clinical response and 33 percent achieved remission with qingdai.

Shomron Ben-Horin, MD, lead author of the new study and chief of gastroenterology at Sheba Medical Center at Tel-Aviv University in Israel, suggests that patients interested in taking curcumin and qingdai only do this in consultation with an IBD specialist. In his own clinic, Dr. Ben-Horin says patients with active ulcerative colitis may take curcumin and qingdai in addition to traditional medications.

“We always advocate using it as an adjunct agent with any biologic or other medication the patient is taking, and do it after proper consultation with the treating physician,” Ben-Horin says.