Abstract

Aim Less than half of all patients with Crohn's disease remain in remission with long‐term use of azathioprine. Our aim was to assess the efficacy of Artesunate and Curcumin in maintaining remission in patients with Crohn's disease, who had ongoing evidence of disease activity despite taking azathioprine. Methods Patients with Crohn's disease being treated with azathioprine for at least 3 months but still had mild to moderate Crohn's disease (CDAI 150–450) were included. Patients were randomized into four blocks of 10 patients each in a 2 × 2 factorial design to receive artesunate 200 mg PO daily for 2 weeks and/or curcumin 200 mg PO daily for 3 months or placebo. Harvey–Bradshaw Index, CDAI, and fecal calprotectin were measured at baseline, 1 week, 1 month, 3 months, and 6 months. Results Forty patients were recruited and randomized into the study. Both Artesunate and Curcumin were well tolerated with no adverse effects. The Harvey–Bradshaw Index statistically differed across the treatment groups at 6 months (p = 0.047), there were no significant group differences in the post hoc pairwise analysis. The differences in CDAI from baseline to 6 months were statistically significant in Artesunate + Curcumin (p = 0.0098) and Curcumin + Placebo (p = 0.0431) groups. Similarly, statistically significant differences were observed between Baseline and 6 months for the Harvey–Bradshaw Index in the Artesunate + Curcumin (p = 0.0070) and Curcumin + Placebo (p = 0.0138) groups. Conclusion A combination of artesunate and curcumin in patients with ongoing inflammatory activity appears to be effective as measured by CDAI and Harvey–Bradshaw Index.