Effects of high‐dose fish oil on rheumatoid arthritis after stopping nonsteroidal antiinflammatory drugs clinical and immune correlates
- 1 August 1995
- journal article
- clinical trial
- Published by Wiley in Arthritis & Rheumatism
- Vol. 38 (8), 1107-1114
- https://doi.org/10.1002/art.1780380813
Abstract
Objective. To determine the following: 1) whether dietary supplementation with fish oil will allow the discontinuation of nonsteroidal antiinflammatory drugs (NSAIDs) in patients with rheumatoid arthritis (RA); 2) the clinical efficacy of high‐dose dietary ω3 fatty acid fish oil supplementation in RA patients; and 3) the effect of fish oil supplements on the production of multiple cytokines in this population. Methods. Sixty‐six RA patients entered a double‐blind, placebo‐controlled, prospective study of fish oil supplementation while taking diclofenac (75 mg twice a day). Patients took either 130 mg/kg/day of ω3 fatty acids or 9 capsules/day of corn oil. Placebo diclofenac was substituted at week 18 or 22, and fish oil supplements were continued for 8 weeks (to week 26 or 30). Serum levels of interleukin‐1β (IL‐1β), IL‐2, IL‐6, and IL‐8 and tumor necrosis factor α were measured by enzyme‐linked immunosorbent assay at baseline and during the study. Results. In the group taking fish oil, there were significant decreases from baseline in the mean (±SEM) number of tender joints (5.3 ± 0.835; P < 0.0001), duration of morning stiffness (−67.7 ± 23.3 minutes; P = 0.008), physician's and patient's evaluation of global arthritis activity (−0.33 ± 0.13; P = 0.017 and −0.38 ± 0.17; P = 0.036, respectively), and physician's evaluation of pain (−0.38 ± 0.12; P = 0.004). In patients taking corn oil, no clinical parameters improved from baseline. The decrease in the number of tender joints remained significant 8 weeks after discontinuing diclofenac in patients taking fish oil (−7.8 ± 2.6; P = 0.011) and the decrease in the number of tender joints at this time was significant compared with that in patients receiving corn oil (P = 0.043). IL‐1β decreased significantly from baseline through weeks 18 and 22 in patients consuming fish oil (−7.7 ± 3.1; P = 0.026). Conclusion. Patients taking dietary supplements of fish oil exhibit improvements in clinical parameters of disease activity from baseline, including the number of tender joints, and these improvements are associated with significant decreases in levels of IL‐1β from baseline. Some patients who take fish oil are able to discontinue NSAIDs without experiencing a disease flare.Keywords
This publication has 29 references indexed in Scilit:
- Dietary fish oil and olive oil supplementation in patients with Rheumatoid Arthritis clinical and immunologic effectsArthritis & Rheumatism, 1990
- Delayed diagnosis of gynecologic tumors in elderly women: Relation to national medical practice patternsThe American Journal of Medicine, 1989
- The Antihypertensive Effects of Fish OilThe New England Journal of Medicine, 1989
- The Effect of Dietary Supplementation with n—3 Polyunsaturated Fatty Acids on the Synthesis of Interleukin-1 and Tumor Necrosis Factor by Mononuclear CellsThe New England Journal of Medicine, 1989
- Cardiovascular Effects of n-3 Fatty AcidsThe New England Journal of Medicine, 1988
- The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritisArthritis & Rheumatism, 1988
- Dietary fat modulation of immune responseInternational Journal of Immunopharmacology, 1986
- Effect of Dietary Enrichment with Eicosapentaenoic and Docosahexaenoic Acids on in Vitro Neutrophil and Monocyte Leukotriene Generation and Neutrophil FunctionThe New England Journal of Medicine, 1985
- Paleolithic NutritionThe New England Journal of Medicine, 1985
- Lipids and lymphocyte functionImmunology Today, 1984