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Intake of ω-3 polyunsaturated fatty acids in patients with rheumatoid arthritis: A systematic review and meta-analysis.
Nutrition. 2018 Jan; 45:114-124.e4.N

Abstract

OBJECTIVES

Rheumatoid arthritis (RA) is a chronic, autoimmune inflammatory disease of multiple joints that puts the patient at high risk for developing cardiovascular diseases (CVDs). The aim of the present study was to conduct an up-to-date systematic review and meta-analysis of published randomized controlled trials (RCTs) to assess potential changes in RA disease activity, inflammation, and CVD risk after oral intake of ω-3 polyunsaturated fatty acids.

METHODS

Publications up to July 31, 2016 were examined using the PubMed, SCOPUS, and EMBASE databases.

INCLUSION CRITERIA

English language; human subjects; both sexes; RCTs; oral intake of ω-3 fatty acids; minimum duration of 3 mo; and no medication change throughout intervention. The Cochrane Risk of Bias tool was used to assess quality of trials. We included 20 RCTs, involving 717 patients with RA in the intervention group and 535 RA patients in the control group.

RESULTS

Despite the evidence of overall low quality of trials, consumption of ω-3 fatty acids was found to significantly improve eight disease-activity-related markers. Regarding inflammation, only leukotriene B4 was reduced (five trials, standardized mean difference [SMD], -0.440; 95% confidence interval [CI], -0.676 to -0.205; I2 = 46.5%; P < 0.001). A significant amelioration was found for blood triacylglycerol levels (three trials, SMD, -0.316; 95% CI, -0.561 to -0.070; I2 = 0.0%; P = 0.012).

CONCLUSION

The beneficial properties of ω-3 polyunsaturated fatty acids on RA disease activity confirm the results of previous meta-analyses. Among five proinflammatory markers evaluated, only leukotriene B4 was found to be reduced. However, a positive effect on blood lipid profile of patients with RA was evident, perhaps for the first time.

Authors+Show Affiliations

Department of Dietetics and Nutritional Science, School of Health Science and Education, Harokopio University, Athens, Greece.Department of Dietetics and Nutritional Science, School of Health Science and Education, Harokopio University, Athens, Greece. Electronic address: akaliora@hua.gr.Department of Dietetics and Nutritional Science, School of Health Science and Education, Harokopio University, Athens, Greece.Department of Dietetics and Nutritional Science, School of Health Science and Education, Harokopio University, Athens, Greece.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

28965775

Citation

Gioxari, Aristea, et al. "Intake of Ω-3 Polyunsaturated Fatty Acids in Patients With Rheumatoid Arthritis: a Systematic Review and Meta-analysis." Nutrition (Burbank, Los Angeles County, Calif.), vol. 45, 2018, pp. 114-124.e4.
Gioxari A, Kaliora AC, Marantidou F, et al. Intake of ω-3 polyunsaturated fatty acids in patients with rheumatoid arthritis: A systematic review and meta-analysis. Nutrition. 2018;45:114-124.e4.
Gioxari, A., Kaliora, A. C., Marantidou, F., & Panagiotakos, D. P. (2018). Intake of ω-3 polyunsaturated fatty acids in patients with rheumatoid arthritis: A systematic review and meta-analysis. Nutrition (Burbank, Los Angeles County, Calif.), 45, 114-e4. https://doi.org/10.1016/j.nut.2017.06.023
Gioxari A, et al. Intake of Ω-3 Polyunsaturated Fatty Acids in Patients With Rheumatoid Arthritis: a Systematic Review and Meta-analysis. Nutrition. 2018;45:114-124.e4. PubMed PMID: 28965775.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intake of ω-3 polyunsaturated fatty acids in patients with rheumatoid arthritis: A systematic review and meta-analysis. AU - Gioxari,Aristea, AU - Kaliora,Andriana C, AU - Marantidou,Foteini, AU - Panagiotakos,Demosthenes P, Y1 - 2017/07/08/ PY - 2017/03/01/received PY - 2017/06/06/revised PY - 2017/06/20/accepted PY - 2017/10/3/pubmed PY - 2018/7/18/medline PY - 2017/10/3/entrez KW - Blood lipids KW - Fish oil KW - Inflammation KW - Meta-analysis KW - Polyunsaturated fatty acids KW - Rheumatoid arthritis KW - ω-3 SP - 114 EP - 124.e4 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 45 N2 - OBJECTIVES: Rheumatoid arthritis (RA) is a chronic, autoimmune inflammatory disease of multiple joints that puts the patient at high risk for developing cardiovascular diseases (CVDs). The aim of the present study was to conduct an up-to-date systematic review and meta-analysis of published randomized controlled trials (RCTs) to assess potential changes in RA disease activity, inflammation, and CVD risk after oral intake of ω-3 polyunsaturated fatty acids. METHODS: Publications up to July 31, 2016 were examined using the PubMed, SCOPUS, and EMBASE databases. INCLUSION CRITERIA: English language; human subjects; both sexes; RCTs; oral intake of ω-3 fatty acids; minimum duration of 3 mo; and no medication change throughout intervention. The Cochrane Risk of Bias tool was used to assess quality of trials. We included 20 RCTs, involving 717 patients with RA in the intervention group and 535 RA patients in the control group. RESULTS: Despite the evidence of overall low quality of trials, consumption of ω-3 fatty acids was found to significantly improve eight disease-activity-related markers. Regarding inflammation, only leukotriene B4 was reduced (five trials, standardized mean difference [SMD], -0.440; 95% confidence interval [CI], -0.676 to -0.205; I2 = 46.5%; P < 0.001). A significant amelioration was found for blood triacylglycerol levels (three trials, SMD, -0.316; 95% CI, -0.561 to -0.070; I2 = 0.0%; P = 0.012). CONCLUSION: The beneficial properties of ω-3 polyunsaturated fatty acids on RA disease activity confirm the results of previous meta-analyses. Among five proinflammatory markers evaluated, only leukotriene B4 was found to be reduced. However, a positive effect on blood lipid profile of patients with RA was evident, perhaps for the first time. SN - 1873-1244 UR - https://www.unboundmedicine.com/medline/citation/28965775/Intake_of_ω_3_polyunsaturated_fatty_acids_in_patients_with_rheumatoid_arthritis:_A_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-9007(17)30134-X DB - PRIME DP - Unbound Medicine ER -