RESEARCH - Fish-oil supplements reduce lupus disease activity

[Guest guest]

Fish-oil supplements reduce lupus disease activity

Rheumawire

Aug 30, 2004

Janis

Ulster and Belfast, Northern Ireland - Dietary supplementation with a

commercially available preparation of omega-3 fish oils significantly

reduced symptomatic disease activity in patients with systemic lupus

erythematosus (SLE), Dr Emeir H Duffy (University of Ulster, Northern

Ireland) reports in the August 2004 issue of the Journal of Rheumatology

[1].

" Fish-oil supplementation in patients with SLE having mild to moderately

active disease would appear to be beneficial; and since the US Food and

Drug Administration has deemed fish-oil supplementation safe, further

investigation of the effect of fish oils in SLE is warranted, " Duffy

writes.

This double-blind, double placebo-controlled trial included 52 patients

with SLE. The investigators set out to measure the effects on SLE

activity of dietary supplements containing omega-3 fish oils and also of

supplements containing copper. These 2 supplements were of interest

because studies in animal models of lupus had suggested that they might

influence disease activity.

Patients with SLE have low levels of omega-3 polyunsaturated fatty acids

such as alpha-linolenic acids, gamma-linolenic acids, eicosapentaenoic

acid (EPA), and docosahexaenoic acid (DHA). " Recent work suggests there

is a valuable role for omega-3 polyunsaturated fatty acids as

anti-inflammatory agents. These fatty acids may also have antiautoimmune

properties, " Duffy notes. " Investigations with murine models of SLE

suggest that the type of fat consumed will determine the severity of

disease. Application of the findings from murine models to human studies

has led to speculation that fish-oil supplementation may be beneficial,

but the precise dosage required and the time for effect [were] unknown. "

Similarly, copper supplementation was of interest because exogenous

copper decreased disease activity in animal models of lupus, Duffy said.

The investigators tested the effects of supplementation with either or

both of these components by randomizing patients to a 2x2 factorial

design. The 4 treatments tested were: both fish oil and copper; fish oil

and placebo copper; copper and placebo fish oil; and placebo copper with

placebo fish oil. Patients took their assigned supplements daily for 24

weeks and were assessed at baseline, 6, 12, and 24 weeks.

The fish-oil supplement was MaxEPA (Seven Seas Ltd, Hull, UK). The

manufacturer provided a visually identical placebo capsule containing

olive oil that had a peppermint flavor to conceal taste and odor.

Patients assigned to fish oil took 3 1-g MaxEPA capsules daily,

providing omega-3 fatty acids roughly equivalent to 2 oily-fish-based

meals per week. Each 1-g capsule contained 18% EPA, 12% DHA, and 1-IU

vitamin E as a protective antioxidant. Patients assigned to placebo fish

oil also took 3 capsules per day.

The copper supplement provided 3 mg of copper per day in the form of

copper diglycinate amino acid complex ( & ph Ltd, Norwich,

UK). The manufacturer provided visually identical placebo capsules that

were analogous in odor and taste. Patients took 1 copper or placebo

capsule per day.

Disease activity was measured using the revised Systemic Lupus Activity

Measure (SLAM-R). Dietary intakes were assessed using 3-day food

diaries.

Duffy reported that 65 patients with SLE agreed to participate, and 52

completed all 24 weeks of the intervention study. Of the patients, 27

took a fish-oil supplement and 25 took a copper supplement.

Patients taking fish oil (with or without copper) had significant

decreases in SLAM-R score after 24 weeks, from 6.12 to 4.69 (p<0.05). No

such decreases were observed in patients who took placebo. " The

components of SLAM-R most affected by fish-oil supplementation were the

integument, neuromotor, and laboratory domains, " Duffy said.

Copper supplements did not produce significant changes when compared

with placebo and did not add significant efficacy when combined with

fish oil.

" This study demonstrates that supplementation with doses of omega-3 fish

oils, which are easily achievable by dietary modification, reduces

symptomatic disease activity in patients with SLE. . . . The supplements

were well tolerated, with no reports of drug interactions, " the

investigators conclude.

Source

Duffy EM, Meenagh GK, McMillan SA, et al. The

clinical effect of dietary supplementation with omega-3 fish oils and or

copper in systemic lupus erythematosus. J Rheumatol 2004;

31:1551-1556.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org