Background Omega-3 polyunsaturated fatty acids (PUVAs) may lead to a reduction of pain and inflammation via competitively inhibiting the production of PGE2 and LTB4 and inhibiting the release of interleukin-1 beta and tumor necrosis factor-alpha.
Objectives The aim of this study was to assess the effects of omega-3 polyunsaturated fatty acids (PUVAs) (at least 2.7 g) for a minimum duration of 3 months on clinical outcomes in patients with rheumatoid arthritis (RA).
Methods The authors surveyed randomized controlled trials (RCTs) that examined the effects of omega-3 PUVAs on clinical outcomes in RA patients using Medline, the Cochrane Controlled Trials Register, and by performing manual searches. Meta-analysis of RCT was performed using fixed and random effects models and outcomes are presented as standardized mean differences (SMD).
Results Ten RCTs involving total of 183 patients and 187 controls were included in this meta-analysis. Meta-analysis showed that omega-3 PUVA had a clear effect versus controls on NSAID consumption (SMD -0.518, 95% CI -0.915 to -0.121, p =0.011), without between-study heterogeneity (I2 =0%). Patients receiving omega-3 PUVAs fared better than placebo for NSIAD consumption. Although they did not reach statistical significance, tender joint count, swollen joint count, morning stiffness, and physical function was observed to improve in the omega-3 PUVAs group (SMD -0.214, 95% CI -0.489 to 0.062, p =0.128; SMD -0.170, 95% CI -0.454 to 0.114, p=0.241: SMD -0.224, 95% CI -0.955 to 0.212, p =0.221; SMD 0.264, 95% CI -0.232 to 0.724 p =0.314).
Conclusions This meta-analysis shows that use of omega-3 PUVAs, at dosages of >2.7 g/day, for more than 3 months may be effective in reducing NSAID use in RA patients. Further studies are needed to explore clinical effects including NSAID sparing effect of omega-3 PUVAs in RA.
Disclosure of Interest None Declared
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