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Effect of omega-3 (n-3) fatty acid supplementation in patients with sickle cell anemia: randomized, double-blind, placebo-controlled trial.
Am J Clin Nutr 2013; 97(1):37-44AJ

Abstract

BACKGROUND

Blood cell aggregation and adherence to vascular endothelium and inflammation play a central role in vaso-occlusive crisis in sickle cell disease. The antiaggregatory, antiadhesive, antiinflammatory, and vasodilatory omega-3 (n-3) fatty acids (DHA and EPA) are significantly reduced in patients with the disease.

OBJECTIVE

The aim was to investigate the therapeutic potential of omega-3 fatty acids for patients with homozygous sickle cell disease in a randomized, placebo-controlled, double-blind trial.

DESIGN

One hundred forty patients recruited from a single center in Sudan were randomly assigned and received, daily, 1 (age 2-4 y), 2 (age 5-10 y), 3 (age 11-16 y), or 4 (age ≥17 y) omega-3 capsules containing 277.8 mg DHA and 39.0 mg EPA or placebo for 1 y. Of these patients, 128 were followed up and the data were obtained. The primary and secondary endpoints-rates of clinical vaso-occlusive crisis and hemolytic events, blood transfusion rate, school attendance, and blood count-were analyzed by intention-to-treat analysis (n = 140).

RESULTS

Omega-3 treatment reduced the median rate of clinical vaso-occlusive events (0 compared with 1.0 per year, P < 0.0001), severe anemia (3.2% compared with 16.4%; P < 0.05), blood transfusion (4.5% compared with 16.4%; P < 0.05), white blood cell count (14.4 ± 3.3 compared with 15.6 ± 4.0 ×10(3)/μL; P < 0.05), and the OR of the inability to attend school at least once during the study period because of illness related to the disease to 0.4 (95% CI: 0.2, 0.9; P < 0.05).

CONCLUSION

The findings of this trial, which need to be verified in a large multicenter study, suggest that omega-3 fatty acids can be an effective, safe, and affordable therapy for sickle cell anemia. This trial was registered with Current Controlled Trials as ISRCTN80844630.

Authors+Show Affiliations

Faculty of Life Sciences and Computing, London Metropolitan University, London, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

23193009

Citation

Daak, Ahmed A., et al. "Effect of Omega-3 (n-3) Fatty Acid Supplementation in Patients With Sickle Cell Anemia: Randomized, Double-blind, Placebo-controlled Trial." The American Journal of Clinical Nutrition, vol. 97, no. 1, 2013, pp. 37-44.
Daak AA, Ghebremeskel K, Hassan Z, et al. Effect of omega-3 (n-3) fatty acid supplementation in patients with sickle cell anemia: randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2013;97(1):37-44.
Daak, A. A., Ghebremeskel, K., Hassan, Z., Attallah, B., Azan, H. H., Elbashir, M. I., & Crawford, M. (2013). Effect of omega-3 (n-3) fatty acid supplementation in patients with sickle cell anemia: randomized, double-blind, placebo-controlled trial. The American Journal of Clinical Nutrition, 97(1), pp. 37-44. doi:10.3945/ajcn.112.036319.
Daak AA, et al. Effect of Omega-3 (n-3) Fatty Acid Supplementation in Patients With Sickle Cell Anemia: Randomized, Double-blind, Placebo-controlled Trial. Am J Clin Nutr. 2013;97(1):37-44. PubMed PMID: 23193009.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of omega-3 (n-3) fatty acid supplementation in patients with sickle cell anemia: randomized, double-blind, placebo-controlled trial. AU - Daak,Ahmed A, AU - Ghebremeskel,Kebreab, AU - Hassan,Zahir, AU - Attallah,Bakhita, AU - Azan,Haj H, AU - Elbashir,Mustafa I, AU - Crawford,Michael, Y1 - 2012/11/28/ PY - 2012/11/30/entrez PY - 2012/11/30/pubmed PY - 2013/3/8/medline SP - 37 EP - 44 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 97 IS - 1 N2 - BACKGROUND: Blood cell aggregation and adherence to vascular endothelium and inflammation play a central role in vaso-occlusive crisis in sickle cell disease. The antiaggregatory, antiadhesive, antiinflammatory, and vasodilatory omega-3 (n-3) fatty acids (DHA and EPA) are significantly reduced in patients with the disease. OBJECTIVE: The aim was to investigate the therapeutic potential of omega-3 fatty acids for patients with homozygous sickle cell disease in a randomized, placebo-controlled, double-blind trial. DESIGN: One hundred forty patients recruited from a single center in Sudan were randomly assigned and received, daily, 1 (age 2-4 y), 2 (age 5-10 y), 3 (age 11-16 y), or 4 (age ≥17 y) omega-3 capsules containing 277.8 mg DHA and 39.0 mg EPA or placebo for 1 y. Of these patients, 128 were followed up and the data were obtained. The primary and secondary endpoints-rates of clinical vaso-occlusive crisis and hemolytic events, blood transfusion rate, school attendance, and blood count-were analyzed by intention-to-treat analysis (n = 140). RESULTS: Omega-3 treatment reduced the median rate of clinical vaso-occlusive events (0 compared with 1.0 per year, P < 0.0001), severe anemia (3.2% compared with 16.4%; P < 0.05), blood transfusion (4.5% compared with 16.4%; P < 0.05), white blood cell count (14.4 ± 3.3 compared with 15.6 ± 4.0 ×10(3)/μL; P < 0.05), and the OR of the inability to attend school at least once during the study period because of illness related to the disease to 0.4 (95% CI: 0.2, 0.9; P < 0.05). CONCLUSION: The findings of this trial, which need to be verified in a large multicenter study, suggest that omega-3 fatty acids can be an effective, safe, and affordable therapy for sickle cell anemia. This trial was registered with Current Controlled Trials as ISRCTN80844630. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/23193009/full_citation L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.112.036319 DB - PRIME DP - Unbound Medicine ER -