Tags

Type your tag names separated by a space and hit enter

Effects of altering dietary essential fatty acids on requirements for non-steroidal anti-inflammatory drugs in patients with rheumatoid arthritis: a double blind placebo controlled study.

Abstract

In rheumatoid arthritis (RA) benefit from non-steroidal anti-inflammatory drugs (NSAIDs) is mediated through inhibition of the cyclo-oxygenase enzyme, thereby decreasing production of the 2 series prostaglandins (PGs). The lipoxygenase enzyme is intact, however, allowing leucotriene (LT) production, e.g., LTB4 (an inflammatory mediator). Treatment with evening primrose oil (EPO) which contains gamma-linolenic acid (GLA) leads to production of the 1 series PGs, e.g., PGE1, which has less inflammatory effects. Also LT production is inhibited. Eicosapentaenoic acid (EPA, fish oil) treatment provides a substrate for PGs and LTs, which are also less inflammatory. In this study 16 patients with RA were given 540 mg GLA/day (EPO), 15 patients 240 mg EPA and 450 mg GLA/day (EPO/fish oil), and 18 patients an inert oil (placebo). The aim of this study was to determine if EPO or EPO/fish oil could replace NSAID treatment in RA. The initial 12 month treatment period was followed by three months of placebo for all groups. Results at 12 months showed a significant subjective improvement for EPO and EPO/fish oil compared with placebo. In addition, by 12 months the patients receiving EPO and EPO/fish oil had significantly reduced their NSAIDs. After 3 months of placebo those receiving active treatment had relapsed. Despite the decrease in NSAIDs, measures of disease activity did not worsen. It is suggested that EPO and EPO/fish oil produce a subjective improvement and allow some patients to reduce or stop treatment with NSAIDs. There is, however, no evidence that they act as disease modifying agents.

Links

  • PMC Free PDF
  • PMC Free Full Text
  • FREE Publisher Full Text
  • Authors+Show Affiliations

    ,

    Centre for Rheumatic Diseases, University Department of Medicine, Royal Infirmary.

    , , ,

    Source

    Annals of the rheumatic diseases 47:2 1988 Feb pg 96-104

    MeSH

    Adult
    Aged
    Anti-Inflammatory Agents, Non-Steroidal
    Arthritis, Rheumatoid
    Clinical Trials as Topic
    Double-Blind Method
    Drug Therapy, Combination
    Eicosapentaenoic Acid
    Fatty Acids, Essential
    Female
    Humans
    Linoleic Acids
    Male
    Middle Aged
    Plant Oils
    Random Allocation
    gamma-Linolenic Acid

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    2833184

    Citation

    Belch, J J., et al. "Effects of Altering Dietary Essential Fatty Acids On Requirements for Non-steroidal Anti-inflammatory Drugs in Patients With Rheumatoid Arthritis: a Double Blind Placebo Controlled Study." Annals of the Rheumatic Diseases, vol. 47, no. 2, 1988, pp. 96-104.
    Belch JJ, Ansell D, Madhok R, et al. Effects of altering dietary essential fatty acids on requirements for non-steroidal anti-inflammatory drugs in patients with rheumatoid arthritis: a double blind placebo controlled study. Ann Rheum Dis. 1988;47(2):96-104.
    Belch, J. J., Ansell, D., Madhok, R., O'Dowd, A., & Sturrock, R. D. (1988). Effects of altering dietary essential fatty acids on requirements for non-steroidal anti-inflammatory drugs in patients with rheumatoid arthritis: a double blind placebo controlled study. Annals of the Rheumatic Diseases, 47(2), pp. 96-104.
    Belch JJ, et al. Effects of Altering Dietary Essential Fatty Acids On Requirements for Non-steroidal Anti-inflammatory Drugs in Patients With Rheumatoid Arthritis: a Double Blind Placebo Controlled Study. Ann Rheum Dis. 1988;47(2):96-104. PubMed PMID: 2833184.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effects of altering dietary essential fatty acids on requirements for non-steroidal anti-inflammatory drugs in patients with rheumatoid arthritis: a double blind placebo controlled study. AU - Belch,J J, AU - Ansell,D, AU - Madhok,R, AU - O'Dowd,A, AU - Sturrock,R D, PY - 1988/2/1/pubmed PY - 1988/2/1/medline PY - 1988/2/1/entrez SP - 96 EP - 104 JF - Annals of the rheumatic diseases JO - Ann. Rheum. Dis. VL - 47 IS - 2 N2 - In rheumatoid arthritis (RA) benefit from non-steroidal anti-inflammatory drugs (NSAIDs) is mediated through inhibition of the cyclo-oxygenase enzyme, thereby decreasing production of the 2 series prostaglandins (PGs). The lipoxygenase enzyme is intact, however, allowing leucotriene (LT) production, e.g., LTB4 (an inflammatory mediator). Treatment with evening primrose oil (EPO) which contains gamma-linolenic acid (GLA) leads to production of the 1 series PGs, e.g., PGE1, which has less inflammatory effects. Also LT production is inhibited. Eicosapentaenoic acid (EPA, fish oil) treatment provides a substrate for PGs and LTs, which are also less inflammatory. In this study 16 patients with RA were given 540 mg GLA/day (EPO), 15 patients 240 mg EPA and 450 mg GLA/day (EPO/fish oil), and 18 patients an inert oil (placebo). The aim of this study was to determine if EPO or EPO/fish oil could replace NSAID treatment in RA. The initial 12 month treatment period was followed by three months of placebo for all groups. Results at 12 months showed a significant subjective improvement for EPO and EPO/fish oil compared with placebo. In addition, by 12 months the patients receiving EPO and EPO/fish oil had significantly reduced their NSAIDs. After 3 months of placebo those receiving active treatment had relapsed. Despite the decrease in NSAIDs, measures of disease activity did not worsen. It is suggested that EPO and EPO/fish oil produce a subjective improvement and allow some patients to reduce or stop treatment with NSAIDs. There is, however, no evidence that they act as disease modifying agents. SN - 0003-4967 UR - https://www.unboundmedicine.com/medline/citation/2833184/full_citation L2 - http://ard.bmj.com/cgi/pmidlookup?view=long&pmid=2833184 DB - PRIME DP - Unbound Medicine ER -