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Maintenance of remission in inflammatory bowel disease using omega-3 fatty acids (fish oil): a systematic review and meta-analyses.
Inflamm Bowel Dis 2011; 17(1):336-45IB

Abstract

The objective was to systematically review the efficacy and safety of n-3 (omega-3 fatty acids, fish oil) for maintaining remission in Crohn's disease (CD) and ulcerative colitis (UC). Electronic databases were searched systematically for randomized controlled trials of n-3 for maintenance of remission in inflammatory bowel disease (IBD). Studies of patients of any age group who were in remission at the time of recruitment and were followed for at least 6 months were included. The primary outcome was relapse rate at the end of the follow-up period. Nine studies were eligible for inclusion; six studies of CD (n = 1039) and three of UC (n = 138). There was a statistically significant benefit for n-3 in CD (relative risk [RR] 0.77; 95% confidence interval [CI] 0.61-0.98); however, the studies were heterogeneous (I(2) = 58%). The absolute risk reduction was -0.14 (95% CI: -0.25 to -0.02). Opinions may vary on whether this is a clinically significant effect. Two well-done studies with a larger sample size reported no benefit. A sensitivity analysis excluding a small pediatric study resulted in the pooled RR being no longer statistically significant. A funnel plot analysis suggested publication bias for the smaller studies. For UC, there was no difference in the relapse rate between the n-3 and control groups (RR 1.02; 95% CI: 0.51-2.03). The pooled analysis showed a higher rate of diarrhea (RR 1.36; 95% CI: 1.01-1.84) and symptoms of the upper gastrointestinal tract (RR 1.96; 95% CI: 1.37-2.80) in the n-3 treatment group. There are insufficient data to recommend the use of omega 3 fatty acids for maintenance of remission in CD and UC.

Authors+Show Affiliations

Pediatric Gastroenterology Unit, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Israel. turnerd@szmc.org.ilNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

20564531

Citation

Turner, Dan, et al. "Maintenance of Remission in Inflammatory Bowel Disease Using Omega-3 Fatty Acids (fish Oil): a Systematic Review and Meta-analyses." Inflammatory Bowel Diseases, vol. 17, no. 1, 2011, pp. 336-45.
Turner D, Shah PS, Steinhart AH, et al. Maintenance of remission in inflammatory bowel disease using omega-3 fatty acids (fish oil): a systematic review and meta-analyses. Inflamm Bowel Dis. 2011;17(1):336-45.
Turner, D., Shah, P. S., Steinhart, A. H., Zlotkin, S., & Griffiths, A. M. (2011). Maintenance of remission in inflammatory bowel disease using omega-3 fatty acids (fish oil): a systematic review and meta-analyses. Inflammatory Bowel Diseases, 17(1), pp. 336-45. doi:10.1002/ibd.21374.
Turner D, et al. Maintenance of Remission in Inflammatory Bowel Disease Using Omega-3 Fatty Acids (fish Oil): a Systematic Review and Meta-analyses. Inflamm Bowel Dis. 2011;17(1):336-45. PubMed PMID: 20564531.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maintenance of remission in inflammatory bowel disease using omega-3 fatty acids (fish oil): a systematic review and meta-analyses. AU - Turner,Dan, AU - Shah,Prakesh S, AU - Steinhart,A Hillary, AU - Zlotkin,Stanley, AU - Griffiths,Anne M, PY - 2010/6/22/entrez PY - 2010/6/22/pubmed PY - 2011/5/13/medline SP - 336 EP - 45 JF - Inflammatory bowel diseases JO - Inflamm. Bowel Dis. VL - 17 IS - 1 N2 - The objective was to systematically review the efficacy and safety of n-3 (omega-3 fatty acids, fish oil) for maintaining remission in Crohn's disease (CD) and ulcerative colitis (UC). Electronic databases were searched systematically for randomized controlled trials of n-3 for maintenance of remission in inflammatory bowel disease (IBD). Studies of patients of any age group who were in remission at the time of recruitment and were followed for at least 6 months were included. The primary outcome was relapse rate at the end of the follow-up period. Nine studies were eligible for inclusion; six studies of CD (n = 1039) and three of UC (n = 138). There was a statistically significant benefit for n-3 in CD (relative risk [RR] 0.77; 95% confidence interval [CI] 0.61-0.98); however, the studies were heterogeneous (I(2) = 58%). The absolute risk reduction was -0.14 (95% CI: -0.25 to -0.02). Opinions may vary on whether this is a clinically significant effect. Two well-done studies with a larger sample size reported no benefit. A sensitivity analysis excluding a small pediatric study resulted in the pooled RR being no longer statistically significant. A funnel plot analysis suggested publication bias for the smaller studies. For UC, there was no difference in the relapse rate between the n-3 and control groups (RR 1.02; 95% CI: 0.51-2.03). The pooled analysis showed a higher rate of diarrhea (RR 1.36; 95% CI: 1.01-1.84) and symptoms of the upper gastrointestinal tract (RR 1.96; 95% CI: 1.37-2.80) in the n-3 treatment group. There are insufficient data to recommend the use of omega 3 fatty acids for maintenance of remission in CD and UC. SN - 1536-4844 UR - https://www.unboundmedicine.com/medline/citation/20564531/Maintenance_of_remission_in_inflammatory_bowel_disease_using_omega_3_fatty_acids__fish_oil_:_a_systematic_review_and_meta_analyses_ L2 - http://Insights.ovid.com/pubmed?pmid=20564531 DB - PRIME DP - Unbound Medicine ER -