Fish oil enhanced the efficacy of low-dose cyclophosphamide regimen for proliferative lupus nephritis: a randomized controlled double-blind trial
Open Access
- 26 July 2021
- journal article
- research article
- Published by SNF Swedish Nutrition Foundation in Food & Nutrition Research
Abstract
Background: Lupus nephritis (LN) is one of the most severe organ that damages the systemic lupus erythematosus (SLE). Cyclophosphamide is one of the main drugs used in the treatment of LN. Fish oil is a general term of all the oily substances in fish, whose main component is omega-3 fatty acid. This study aimed to investigate whether fish oil could be used as an adjunct to low-dose cyclophosphamide in proliferative LN treatment. Methods: A total of 237 patients with proliferative LN were recruited and randomized into two groups: cyclophosphamide + placebo group and cyclophosphamide + fish oil group. In the cyclophosphamide + placebo group, participants received prednisone + cyclophosphamide + placebo. In the cyclophosphamide + fish oil group, participants received prednisone + cyclophosphamide + fish oil. Before and after treatment, the clinical parameters of the patients in both groups were evaluated. Results: In the cyclophosphamide + fish oil group, the number of patients achieving complete remission (n = 45, 46.9%) was significantly higher than the cyclophosphamide + placebo group (n = 31, 32.6%). The number of patients achieving no response in the cyclophosphamide + fish oil group (n = 8, 8.3%) was significantly lower than the cyclophosphamide + placebo group (n = 22, 23.2%). Hematuria (P = 0.036), urine protein-creatinine ratio (uPCR) (P = 0.014), estimated glomerular filtration rate (eGFR) (P = 0.027), and renal SLE disease activity index (SLEDAI) (P = 0.009) improved more significantly in the cyclophosphamide + fish oil group. The number of patients with infection (P = 0.04) or urinary tract infection (P = 0.04) in the cyclophosphamide + fish oil group was lower than the cyclophosphamide + placebo group. Conclusion: In conclusion, the treatment of fish oil in LN patients enhances the efficiency of cyclophosphamide, alleviates nephritis-related parameters, and inhibits infection and urinary tract infection during the treatment. Thus, fish oil may serve as a potential adjuvant drug in the treatment of LN.Keywords
This publication has 30 references indexed in Scilit:
- Lupus nephritis: A critical reviewAutoimmunity Reviews, 2012
- The KDIGO practice guideline on glomerulonephritis: reading between the (guide)lines—application to the individual patientKidney International, 2012
- Omega‐3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology?British Journal of Clinical Pharmacology, 2012
- American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritisArthritis Care & Research, 2012
- SLE: challenges and candidates in human diseaseTrends in Immunology, 2005
- Suppressive effects of fish oil on mesangial cell proliferation in vitro and in vivoKidney International, 2000
- Beneficial effects of chronic administration of dietary ω-3 polyunsaturated fatty acids in dogs with renal insufficiencyJournal of Laboratory and Clinical Medicine, 1998
- Fish oil feeding modulates leukotriene production in murine lupus nephritisProstaglandins, 1994
- Decreased Proinflammatory Cytokines and Increased Antioxidant Enzyme Gene Expression by ω-3 Lipids in Murine Lupus NephritisBiochemical and Biophysical Research Communications, 1994
- Fish oil in lupus nephritis: Clinical findings and methodological implicationsKidney International, 1993