A Clinical Trial to Evaluate the Chronic Safety and Tolerance of Turmipure Gold™ in Healthy Subjects — TURBIO-GOLD  

Gastrointestinal Tolerance Clinical Trial

Official title: A Double-blind Placebo-controlled Clinical Trial to Evaluate the Chronic Safety and Tolerance of Turmipure Gold™ in Healthy Subjects

Status Completed

Clinical Trial Summary

The aim of this study is to evaluate the safety and tolerance of Turmipure Gold™ product during a chronic consumption of 5 weeks in healthy subjects. The hypothesis of this study is that there are no alterations of the gastrointestinal tolerance, of the haematological and biochemical profiles due to Turmipure Gold™ consumption compared to placebo.

Clinical Trial Description

The rhizome of Curcuma longa (turmeric) is commonly used as a spice and for its medicinal proprieties traditionally in Asian countries. Turmeric has been studying in different therapeutic area. Antioxidant, anti-inflammatory (respiratory system, joints and digestive), antimutagenic, antimicrobial, neurological disease, hepatoprotective and anticancer properties are supported by in vitro and in vivo data.

Despite several data identified in the scientific literature, the community herbal monograph of the European Medicines Agency allows the traditional use only for the following therapeutic indication "Traditional herbal medicinal product used to increase bile flow for the relief of symptoms of indigestion (such as sensation of fullness, flatulence, and slow digestion)." According to the World Health Organization (WHO) Monographs on Selected Medicinal Plants, the use for treatment of acid, flatulent, or atonic dyspepsia is supported by clinical data. Treatment of peptic ulcers, and pain and inflammation due to rheumatoid arthritis and of amenorrhoea, dysmenorrhoea, diarrhoea, epilepsy, pain, and skin diseases are uses described in pharmacopoeias and in traditional systems of medicine.

Several health claims are pending for European Commission's decision (referred to the Regulation n°1924/2006). As a consequence, in European countries, claims related to antioxidant, joints, digestion, liver, etc. are tolerated for the moment.

Curcumin has been studied as the main bioactive component of turmeric associated to the potential health effect. However, besides curcumin, others components have been identified called the curcuminoids groups. Curcuminoids are natural yellow-orange pigments and hydrophobic polyphenols derived from the rhizome of the herb Curcuma longa. They are commonly isolated from the spice and food-coloring agent turmeric. Extracts of curcuminoids generally contain 75-80% curcumin, 15-20% demethoxycurcumin (DMC), and 0-10% bisdemethoxycurcumin (BDMC).

Regarding the intrinsic property, curcuminoids have higher solubility in organic solvents than in water. As a consequence, curcumin has low aqueous solubility and poor gastrointestinal absorption. It was also documented that curcumin have low absorption from the gut, rapid metabolism and rapid systemic elimination. This leads to the conclusion that turmeric has low bioavailability, which limits its use in general health care and as an adjunct in managing various diseases. Indeed, it was found low serum levels and limited tissue distribution irrespective of route of administration. In order to improve the bioavailability of curcumin, several approaches have been undertaken. The use of adjuvant like piperine that interferes with glucuronidation; liposomal curcumin, nanoparticles, phospholipid complex; and structural analogues of curcumin. The tested products are different from technology of bioavailability enhancement. Recently, Naturex has developed a dried emulsion formulation using a turmeric extract mixed together with a quillaja extract, sunflower oil and arabic gum. This formulation is highly dispersible in water and should therefore improve the bioavailability of curcuminoids.

In order to assess the bioavailability of the product Turmipure Gold™, Naturex conducted a clinical study in 2018. The plasmatic concentration profile of total curcuminoids (curcumin, DMC, BDMC and their metabolites) on a 24-hour period after consumption of a single dose of 300 mg Turmipure Gold™ 30% curcuminoids formulation in comparison to the one obtained after consumption of 1500 mg Standard turmeric powder extract 95% curcuminoids was investigated as the primary objective (unpublished yet). A statistical significant difference was observed on the primary outcome which was the dose-normalized Area Under the Curve (AUC) 0-24h of Total curcuminoids. Turmipure Gold™ formulation was significantly higher than Standard turmeric powder extract (adjusted p<0.0001) for this parameter.

Thirty subjects received the products in a cross-over design, 16 women and 14 men and no gender effect was observed on the primary outcome.

Statistical significant differences were also observed on the dose-normalized of Area Under the Cuve (AUC0)-24h of Total curcuminoids between products comparisons: Turmipure Gold™ was higher than Turmeric extract (1500mg) combined with piperine (15mg) or the phytosome formulation (1000mg) (adjusted p<0.0001 for each).

The aim of this double-blind placebo-controlled clinical trial is to evaluate the chronic safety and tolerance of Turmipure Gold™ in healthy subjects during 5 weeks +/- 3 days between visit V1 (dispensation of the product) and visit V2 (normal end-of-study). 60 healthy male and female volunteers with 40/60 ratio will be recruited for this study.

In order to assess the gastrointestinal tolerance, a composite score of gastrointestinal tolerance has been chosen as primary endpoint of the trial. The composite score of GI tolerance will be determined as the sum of the scores of the 4 GI symptoms and the composite score of stool frequency and consistency (score of GI tolerance = bloating score + abdominal cramping score + stomach noises score + flatulence score + stool score).

Regarding the safety concern, the European Medicines Agency (EMA) monograph indicate contraindication for the following pathologies: "Hypersensitivity to the active substance(s), obstruction of bile duct, cholangitis, liver disease, gallstones and any other biliary diseases" (confirmed by the WHO monograph). The only undesirable effect reported are "mild symptoms of dry mouth, flatulence and gastric irritation may occur. The frequency is not known." In addition to this, the safety profile of the comparatives products was assessed good in several published trials. This will be investigated deeper in this trial with all the safety and tolerance parameters. An additional end-of-study visit could be planned if the biological results of the V2 visit are not satisfactory, according to the opinion of the investigator. ;

Related Conditions & MeSH terms

• Gastrointestinal Tolerance
• Kidney Function
• Liver Function

• NCT number: NCT03945149
• Study type: Interventional
• Source: Naturex SA
• Status: Completed
• Phase: N/A
• Start date: May 9, 2019
• Completion date: July 26, 2019