Curcumin in Rheumatoid Arthritis

Inclusion Criteria:

1. Age ≥ 18 years; read and understand English

2. Stable dose of non-steroidal anti-inflammatory agents (NSAID) for ≥ 2 weeks.

3. Oral prednisone or equivalent ≤ 10 mg daily and stable dose for ≥ 2 weeks(and must be
kept stable throughout the duration of the protocol).

- ESR > 20 mm/hr, or CRP > 0.8 mg/dl

4. May be using any of the following DMARDs: methotrexate, sulfasalazine,
hydroxychloroquine or leflunomide. If using any of these DMARDs must be using them
for ≥ 12 weeks and stable dose for ≥ 4 weeks. If using other DMARD, or DMARD
combinations, these additional or other DMARDs must be stopped for ≥ 4 weeks before
baseline visit. May also participate if patient not on DMARD,

5. Subjects must be diagnosed with rheumatoid arthritis based on the revised American
College of Rheumatology criteria:Presence of > swollen and > 6 tender joint count (28
joint count), and either ESR > 20 mm/hr or CRP > 0.8 mg/dl

Exclusion Criteria:

1. Acute medical conditions deemed as inappropriate by the investigators (acute heart
failure, uncontrolled diabetes mellitus, uncontrolled hypertension)

2. AST/ALT > 1.5 upper limit of normal (ULN)

3. Serum creatinine > 1.6 mg/dl

4. Hemoglobin/Hematocrit < 10.0 gram/dl/ 30.0

5. Platelet count < 100,000

6. Current use of warfarin (as there is a drug interaction between curcumin and
warfarin).

7. Currently on biologic therapy (must have stopped etanercept for ≥ 4 weeks or
adalimumab or infliximab for ≥ 8 weeks at time of Time 1 visit),

8. Women who are pregnant,

9. Subjects who are taking digoxin, warfarin and/or heparin,

10. Subjects with a history of antiphospholipid syndrome and other thrombophilic states,

11. Subjects who have an INR >= 1.5 at baseline,

12. Subjects with acute episode(s) of cholecystitis within the last 6 months,

13. Subjects with active peptic ulcer disease within the last 6 weeks