AB0375 A systematic literature review of omega 3 in the treatment of rheumatoid arthritis

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 1357
• Main Authors: Prince, M., Bukhari, M.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: Clinical trials; Epidemiology; Literature reviews; Microbiomes; Rheumatoid arthritis; Statistical analysis; Vegetarian diet
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2018-eular.3325

BackgroundMany 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.ObjectivesThis systematic literature review covers one food stuff, omega-3 polyunsaturated fats efficacy in the management of RA alongside or independent of conventional DMARD therapy.MethodsA 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.ResultsThe 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.ConclusionsThis 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 Nutrition2015;114(6):885–90.[2] Epidemiology1996;7(3):256–63.[3] Archives of Medical Research2012;43(5):356–62.[4] Journal of Parenteral and Enteral Nutrition2010;34(2):151–5.[5] Global Journal of Health Science2015;8(7):18.[6] Arthritis Care & Research2017.[7] Rheumatology (Oxford, England)2008;47(5):665–9.[8] Nutrients2017;9(4).Disclosure of InterestNone declaredAbstract AB0375 – Table 1Reference:Study typeParticipants in intervention groupParticipants in control groupOmega-3 doseDurationDid it show efficacy?How did they assess response? Proudman et al1RCT86533.7 g/day1 yearYesSuccess/failure of DMARDsShapiro et al2Case-control3241245>2 servings boiled/baked fish per weekDiet from a 1 year periodYesRA riskLee et al3Meta-analysis183187>2.7 g/day>3 monthsClinical not statistical significanceNSAID consumption, tender/swollen joint count, physical functionBahadori et al4RCT850.2 g/kg– fish oil emulsion22 weeksYesDecrease in swollen and tender joint countsRajaei et al5RCT30303.9 g/day12 weeksYesDAS28Tedeschi et al6Cross sectional analysis31145Eat fish>2 x per week(<5.5 g/day)Diet from past yrYesDAS28Galarraga et al7RCT49482.2 g/day9 monthsYes in reducing NSAID intake but not in DAS28Daily NSAID requirementVeselinovic et al8RCT4020600 mg/day12 weeksYesDAS28