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Nutrient supplementation with polyunsaturated fatty acids and micronutrients in rheumatoid arthritis: clinical and biochemical effects.
Eur J Clin Nutr 2004; 58(6):839-45EJ

Abstract

OBJECTIVE

To investigate in a double-blind placebo-controlled, parallel group study, the effects of a nutrient supplement, containing, among other ingredients, the omega-3 fatty acids eicosapentaenoic acid (1.4 g EPA), docosahexaenoic acid (0.211 g DHA), omega-6 fatty acid gamma-linolenic acid (0.5 g GLA) and micronutrients in patients with active rheumatoid arthritis (RA).

DESIGN, SUBJECTS AND INTERVENTION

RA patients were randomized to receive either daily liquid nutrient supplementation or placebo for 4 months. The primary end point was the change in tender joint count at 2 and 4 months. Other clinical variables included swollen joint count, visual analogue scales for pain and disease activity, grip strength, functionality score and morning stiffness. Biochemical parameters included plasma concentrations of PUFA and vitamins C and E.

SETTING

Outpatient university clinic.

RESULTS

In all, 66 patients enrolled, 55 completed the study. No significant change from baseline in tender joint count or any of the other clinical parameters was detected in either group. Patients receiving nutrient supplementation, but not those receiving placebo, had significant increases in plasma concentrations of vitamin E (P=0.015), and EPA, DHA and docosapentaenoic acid concomitant with decreases of arachidonic acid (P=0.01). Intergroup differences for PUFA and vitamin E were significantly different (P=0.01 and 0.03, respectively).

CONCLUSIONS

This double-blind, placebo-controlled study in RA patients did not show superior clinical benefit of daily nutrient supplementation with EPA, GLA and micronutrients at the doses tested as compared to placebo. The study adds information regarding doses of omega-3 fatty acids, below which anti-inflammatory effects in RA are not seen.

Authors+Show Affiliations

Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15164103

Citation

Remans, P H J., et al. "Nutrient Supplementation With Polyunsaturated Fatty Acids and Micronutrients in Rheumatoid Arthritis: Clinical and Biochemical Effects." European Journal of Clinical Nutrition, vol. 58, no. 6, 2004, pp. 839-45.
Remans PH, Sont JK, Wagenaar LW, et al. Nutrient supplementation with polyunsaturated fatty acids and micronutrients in rheumatoid arthritis: clinical and biochemical effects. Eur J Clin Nutr. 2004;58(6):839-45.
Remans, P. H., Sont, J. K., Wagenaar, L. W., Wouters-Wesseling, W., Zuijderduin, W. M., Jongma, A., ... Van Laar, J. M. (2004). Nutrient supplementation with polyunsaturated fatty acids and micronutrients in rheumatoid arthritis: clinical and biochemical effects. European Journal of Clinical Nutrition, 58(6), pp. 839-45.
Remans PH, et al. Nutrient Supplementation With Polyunsaturated Fatty Acids and Micronutrients in Rheumatoid Arthritis: Clinical and Biochemical Effects. Eur J Clin Nutr. 2004;58(6):839-45. PubMed PMID: 15164103.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutrient supplementation with polyunsaturated fatty acids and micronutrients in rheumatoid arthritis: clinical and biochemical effects. AU - Remans,P H J, AU - Sont,J K, AU - Wagenaar,L W, AU - Wouters-Wesseling,W, AU - Zuijderduin,W M, AU - Jongma,A, AU - Breedveld,F C, AU - Van Laar,J M, PY - 2004/5/28/pubmed PY - 2004/9/8/medline PY - 2004/5/28/entrez SP - 839 EP - 45 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 58 IS - 6 N2 - OBJECTIVE: To investigate in a double-blind placebo-controlled, parallel group study, the effects of a nutrient supplement, containing, among other ingredients, the omega-3 fatty acids eicosapentaenoic acid (1.4 g EPA), docosahexaenoic acid (0.211 g DHA), omega-6 fatty acid gamma-linolenic acid (0.5 g GLA) and micronutrients in patients with active rheumatoid arthritis (RA). DESIGN, SUBJECTS AND INTERVENTION: RA patients were randomized to receive either daily liquid nutrient supplementation or placebo for 4 months. The primary end point was the change in tender joint count at 2 and 4 months. Other clinical variables included swollen joint count, visual analogue scales for pain and disease activity, grip strength, functionality score and morning stiffness. Biochemical parameters included plasma concentrations of PUFA and vitamins C and E. SETTING: Outpatient university clinic. RESULTS: In all, 66 patients enrolled, 55 completed the study. No significant change from baseline in tender joint count or any of the other clinical parameters was detected in either group. Patients receiving nutrient supplementation, but not those receiving placebo, had significant increases in plasma concentrations of vitamin E (P=0.015), and EPA, DHA and docosapentaenoic acid concomitant with decreases of arachidonic acid (P=0.01). Intergroup differences for PUFA and vitamin E were significantly different (P=0.01 and 0.03, respectively). CONCLUSIONS: This double-blind, placebo-controlled study in RA patients did not show superior clinical benefit of daily nutrient supplementation with EPA, GLA and micronutrients at the doses tested as compared to placebo. The study adds information regarding doses of omega-3 fatty acids, below which anti-inflammatory effects in RA are not seen. SN - 0954-3007 UR - https://www.unboundmedicine.com/medline/citation/15164103/Nutrient_supplementation_with_polyunsaturated_fatty_acids_and_micronutrients_in_rheumatoid_arthritis:_clinical_and_biochemical_effects_ L2 - http://dx.doi.org/10.1038/sj.ejcn.1601883 DB - PRIME DP - Unbound Medicine ER -