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AB0375 (2018)
A systematic literature review of omega 3 in the treatment of rheumatoid arthritis
M. Prince1, M. Bukhari2
1Lancaster Medical School, Lancaster University
2Rheumatology, Royal Lancaster Infirmary, Lancaster, UK

 

Background: Many different elements and variations of diet in the management of rheumatoid arthritis (RA) have been studied over the years such as vegan or Mediterranean diets.

Objectives: This systematic literature review covers one food stuff, omega-3 polyunsaturated fats efficacy in the management of RA alongside or independent of conventional DMARD therapy.

Methods: A systematic review of the literature between 1966–2017 was conducted using MEDLINE, CINAHL and EMBASE databases, with key words ”RA” and ”omega-3” for English-language articles producing 209 hits. We then refined to publications within the last 10 years, giving 96 results. Only including clinical trials gave 12 hits pertaining to 8 trials.

Results: The table above shows a summary of the evidence found. In total, 751 were exposed to omega-3 versus 1733 controls with the smallest study being an RCT involving 13 people and the largest a case-control study with 1569 participants. A notable difference between these studies was the use of DMARD therapy as part of the inclusion or exclusion criteria. Another difference noted was the RA stage eligible for a trial. Some studies required a diagnosis of RA of <12 months whereas most required stable RA ongoing for >12 months.

Conclusions: This review concludes that omega-3 leads to clinical and statistically significant improvements in RA. There was a significant heterogeneity in the trials published with different inclusion criteria especially regarding disease duration and concomitant DMARD therapy. It would seem prudent to include dietary advice in our advice to patients when treating RA. Possible reasons for this evidence would include altering the microbiome.

References:

  1. The British Journal of Nutrition 2015;114(6):885–90.
  2. Epidemiology 1996;7(3):256–63.
  3. Archives of Medical Research 2012;43(5):356–62.
  4. Journal of Parenteral and Enteral Nutrition 2010;34(2):151–5.
  5. Global Journal of Health Science 2015;8(7):18.
  6. Arthritis Care & Research 2017.
  7. Rheumatology (Oxford, England) 2008;47(5):665–9.
  8. Nutrients 2017;9(4).

Disclosure of Interest: None declared

DOI: 10.1136/annrheumdis-2018-eular.3325

Abstract AB0375 – Table 1

Reference:

Study type

Participants in intervention group

Participants in control group

Omega-3 dose

Duration

Did it show efficacy?

How did they assess response?

Proudman et al1

RCT

86

53

3.7 g/day

1 year

Yes

Success/failure of DMARDs

Shapiro et al2

Case-control

324

1245

>2 servings boiled/baked fish per week

Diet from a 1 year period

Yes

RA risk

Lee et al3

Meta-analysis

183

187

>2.7 g/day

>3 months

Clinical not statistical significance

NSAID consumption, tender/swollen joint count, physical function

Bahadori et al4

RCT

8

5

0.2 g/kg– fish oil emulsion

22 weeks

Yes

Decrease in swollen and tender joint counts

Rajaei et al5

RCT

30

30

3.9 g/day

12 weeks

Yes

DAS28

Tedeschi et al6

Cross sectional analysis

31

145

Eat fish>2 x per week

(<5.5 g/day)

Diet from past yr

Yes

DAS28

Galarraga et al7

RCT

49

48

2.2 g/day

9 months

Yes in reducing NSAID intake but not in DAS28

Daily NSAID requirement

Veselinovic et al8

RCT

40

20

600 mg/day

12 weeks

Yes

DAS28



Citation: Ann Rheum Dis, volume 77, supplement Suppl, year 2018, page A1357
Session: Rheumatoid arthritis – comorbidity and clinical aspects