https://www.doils.net/v1/links/836150.pdf

n−3 Polyunsaturated fatty acids, inflammation, and inflammatory diseases

Between 40% and 60% of Americans use complementary and alternative medicine to manage medical conditions, prevent disease, and promote health and well-being. Omega-3 polyunsaturated fatty acids (x-3 PUFAs) have been used to treat joint pain associated with several inflammatory conditions. We conducted a meta-analysis of 17 randomized, controlled trials assessing the pain relieving effects of x-3 PUFAs in patients with rheumatoid arthritis or joint pain secondary to inflammatory bowel disease and dysmenorrhea. Meta-analysis was conducted with Cochrane Review Manager 4.2.8. for six separate outcomes using standardized mean differences (SMDs) as a measure of effect size: (1) patient assessed pain, (2) physician assessed pain, (3) duration of morning stiffness, (4) number of painful and/or tender joints, (5) Ritchie articular index, and (6) nonselective nonsteroidal anti-inflammatory drug consumption. Supplementation with x-3 PUFAs for 3–4 months reduces patient reported joint pain intensity (SMD: 0.26; 95% CI: 0.49 to 0.03, p = 0.03), minutes of morning stiffness (SMD: 0.43; 95% CI: 0.72 to 0.15, p = 0.003), number of painful and/or tender joints (SMD: 0.29; 95% CI: 0.48 to 0.10, p = 0.003), and NSAID consumption (SMD: 0.40; 95% CI: 0.72 to 0.08, p = 0.01). Significant effects were not detected for physician assessed pain (SMD: 0.14; 95% CI: 0.49 to 0.22, p = 0.45) or Ritchie articular index (SMD: 0.15; 95% CI: 0.19 to 0.49, p = 0.40) at 3–4 months. The results suggest that x-3 PUFAs are an attractive adjunctive treatment for joint pain associated with rheumatoid arthritis, inflammatory bowel disease, and dysmenorrhea. 2007 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

/pdf/a-meta-analysis-of-the-analgesic-effects-of-omega-3-3dwpr8dnii.pdf

A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease of the joints and bones. The n-6 polyunsaturated fatty acid (PUFA) arachidonic acid (ARA) is the precursor of inflammatory eicosanoids which are involved in RA. Some therapies used in RA target ARA metabolism. Marine n-3 PUFAs (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) found in oily fish and fish oils decrease the ARA content of cells involved in immune responses and decrease the production of inflammatory eicosanoids from ARA. EPA gives rise to eicosanoid mediators that are less inflammatory than those produced from ARA and both EPA and DHA give rise to resolvins that are anti-inflammatory and inflammation resolving, although little is known about these latter mediators in RA. Marine n-3 PUFAs can affect other aspects of immunity and inflammation relevant to RA, including dendritic cell and T cell function and production of inflammatory cytokines and reactive oxygen species, although findings for these outcomes are not consistent. Fish oil has been shown to slow the development of arthritis in animal models and to reduce disease severity. A number of randomised controlled trials of marine n-3 PUFAs have been performed in patients with RA. A systematic review included 23 studies. Evidence is seen for a fairly consistent, but modest, benefit of marine n-3 PUFAs on joint swelling and pain, duration of morning stiffness, global assessments of pain and disease activity, and use of non-steroidal anti-inflammatory drugs.

/pdf/influence-of-marine-n-3-polyunsaturated-fatty-acids-on-35my38p788.pdf

Influence of marine n-3 polyunsaturated fatty acids on immune function and a systematic review of their effects on clinical outcomes in rheumatoid arthritis.

http://www.lyprinol.com/downloads/Kremer%201999,%20AJCM_%20n-3%20Fatty%20Acids%20Arthritis.pdf

n−3 Fatty acid supplements in rheumatoid arthritis

It has been suggested that omega 3 (W3, n-3 or omega-3) fats from oily fish and plants are beneficial to health.
The objective of this review is to assess whether dietary or supplemental omega 3 fatty acids alter total mortality, cardiovascular events or cancers using both RCT and cohort studies.

Omega 3 fatty acids for prevention and treatment of cardiovascular disease

Therapeutic effects of fish oil (10 g/day) in rheumatoid arthritis were investigated in a randomized, controlled, double-blind study. Forty-three patients completing the study were evaluated at 0, 3 and 6 months. The nutrient intake in the fish oil group and in the control group was essentially similar. In the fish oil group, the percentage of n-3 fatty acids in serum phosphatidylcholine increased by 9.6 (range 2.6-16.1). Patients in the fish oil group reported a significantly decreased consumption of NSAID at 3 and 6 months, and the status of global arthritic activity improved at 3 months in physician's assessment. Control patients reported an increased global arthritic activity at 6 months. No change was found in patient assessment of pain, duration of morning stiffness or functional capacity. Essentially no change occurred in biochemical markers of inflammation. We conclude that fish oil has small anti-inflammatory effects with at most a NSAID-saving potential. The value of prolonged supplementation remains to be evaluated.

L Sköldstam

Papers

Effect of Six Months of Fish Oil Supplementation in Stable Rheumatoid Arthritis. A Double-blind, Controlled Study