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Effects of fish oil supplementation on non-steroidal anti-inflammatory drug requirement in patients with mild rheumatoid arthritis--a double-blind placebo controlled study.

Abstract

Maxepa contains eicosapentaenoic acid (EPA) (171 mg/capsule) and docosahexaenoic acid (DHA) (114 mg/capsule). EPA acts as an alternative substrate to arachidonate, leading to the formation of the less proinflammatory prostaglandins ('3' series) and leukotrienes ('5' series). If Maxepa has anti-inflammatory properties it could be expected to reduce the requirement for NSAIDs in patients with RA. This has not been investigated nor has Maxepa therapy been studied over a full 1-yr period. Sixty-four patients with stable RA requiring NSAID therapy only were studied. Patients received either 10 Maxepa or air-filled placebo capsules per day for 12 months. All then received placebo capsules for a further 3 months. Patients were reviewed at 3-monthly intervals. NSAID requirement at entry visit for each patient was assigned as 100%. Patients were instructed to slowly reduce their NSAID dosage providing there was no worsening of their symptoms. Clinical and laboratory parameters of RA activity were also measured. There was a significant reduction in NSAID usage in patients on Maxepa when compared with placebo from month 3 [mean (95% C.I. for mean) requirement--71.1 (55.9-86.2)% and 89.7 (73.7-105.7)%, respectively]. This effect reached its maximum at month 12 [40.6 (24.5-56.6)% and 84.1 (62.7-105.5)%, respectively] and persisted to month 15 [44.7 (27.6-61.8)% and 85.8 (60.5-111.1)%, respectively] (P < 0.001, ANOVA). These patients were able to reduce their NSAID requirement without experiencing any deterioration in the clinical and laboratory parameters of RA activity.

Authors+Show Affiliations

,

Department of Medicine, Ninewells Hospital, Dundee, Scotland.

,

Source

British journal of rheumatology 32:11 1993 Nov pg 982-9

MeSH

Anti-Inflammatory Agents, Non-Steroidal
Arthritis, Rheumatoid
Docosahexaenoic Acids
Double-Blind Method
Drug Combinations
Eicosapentaenoic Acid
Erythrocyte Membrane
Fatty Acids
Fatty Acids, Omega-3
Female
Fish Oils
Humans
Male
Middle Aged
Patient Satisfaction

Pub Type(s)

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

Language

eng

PubMed ID

8220938

Citation

Lau, C S., et al. "Effects of Fish Oil Supplementation On Non-steroidal Anti-inflammatory Drug Requirement in Patients With Mild Rheumatoid Arthritis--a Double-blind Placebo Controlled Study." British Journal of Rheumatology, vol. 32, no. 11, 1993, pp. 982-9.
Lau CS, Morley KD, Belch JJ. Effects of fish oil supplementation on non-steroidal anti-inflammatory drug requirement in patients with mild rheumatoid arthritis--a double-blind placebo controlled study. Br J Rheumatol. 1993;32(11):982-9.
Lau, C. S., Morley, K. D., & Belch, J. J. (1993). Effects of fish oil supplementation on non-steroidal anti-inflammatory drug requirement in patients with mild rheumatoid arthritis--a double-blind placebo controlled study. British Journal of Rheumatology, 32(11), pp. 982-9.
Lau CS, Morley KD, Belch JJ. Effects of Fish Oil Supplementation On Non-steroidal Anti-inflammatory Drug Requirement in Patients With Mild Rheumatoid Arthritis--a Double-blind Placebo Controlled Study. Br J Rheumatol. 1993;32(11):982-9. PubMed PMID: 8220938.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of fish oil supplementation on non-steroidal anti-inflammatory drug requirement in patients with mild rheumatoid arthritis--a double-blind placebo controlled study. AU - Lau,C S, AU - Morley,K D, AU - Belch,J J, PY - 1993/11/1/pubmed PY - 1993/11/1/medline PY - 1993/11/1/entrez SP - 982 EP - 9 JF - British journal of rheumatology JO - Br. J. Rheumatol. VL - 32 IS - 11 N2 - Maxepa contains eicosapentaenoic acid (EPA) (171 mg/capsule) and docosahexaenoic acid (DHA) (114 mg/capsule). EPA acts as an alternative substrate to arachidonate, leading to the formation of the less proinflammatory prostaglandins ('3' series) and leukotrienes ('5' series). If Maxepa has anti-inflammatory properties it could be expected to reduce the requirement for NSAIDs in patients with RA. This has not been investigated nor has Maxepa therapy been studied over a full 1-yr period. Sixty-four patients with stable RA requiring NSAID therapy only were studied. Patients received either 10 Maxepa or air-filled placebo capsules per day for 12 months. All then received placebo capsules for a further 3 months. Patients were reviewed at 3-monthly intervals. NSAID requirement at entry visit for each patient was assigned as 100%. Patients were instructed to slowly reduce their NSAID dosage providing there was no worsening of their symptoms. Clinical and laboratory parameters of RA activity were also measured. There was a significant reduction in NSAID usage in patients on Maxepa when compared with placebo from month 3 [mean (95% C.I. for mean) requirement--71.1 (55.9-86.2)% and 89.7 (73.7-105.7)%, respectively]. This effect reached its maximum at month 12 [40.6 (24.5-56.6)% and 84.1 (62.7-105.5)%, respectively] and persisted to month 15 [44.7 (27.6-61.8)% and 85.8 (60.5-111.1)%, respectively] (P < 0.001, ANOVA). These patients were able to reduce their NSAID requirement without experiencing any deterioration in the clinical and laboratory parameters of RA activity. SN - 0263-7103 UR - https://www.unboundmedicine.com/medline/citation/8220938/Effects_of_fish_oil_supplementation_on_non_steroidal_anti_inflammatory_drug_requirement_in_patients_with_mild_rheumatoid_arthritis__a_double_blind_placebo_controlled_study_ L2 - http://www.diseaseinfosearch.org/result/592 DB - PRIME DP - Unbound Medicine ER -