RESEARCH - Reduction of cardiovascular risk factors with longterm fish oil treatment in early RA

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J Rheumatol. 2006 Aug 1; [Epub ahead of print]

Reduction of Cardiovascular Risk Factors with Longterm Fish Oil Treatment in

Early Rheumatoid Arthritis.

Cleland LG, Caughey GE, MJ, Proudman SM.

OBJECTIVE: Rheumatoid arthritis (RA) is associated with increased risk for

cardiovascular (CV) events through multiple factors. Fish oil has been shown

to reduce symptoms in RA and to reduce CV risk. We assessed the effect of an

antiinflammatory dose of fish oil on CV risk factors within a program of

combination chemotherapy for patients with early RA. METHODS: Patients who

chose not to take fish oil (n = 13) were compared with patients who achieved

a sustained elevation of eicosapentaenoic acid (EPA) in plasma phospholipid

fatty acids (> 5% total fatty acids) while taking fish oil over a 3-year

period (n = 18). We examined cellular content of arachidonic acid (AA),

synthesis of thromboxane A2 and prostaglandin E2, use of nonsteroidal

antiinflammatory drugs (NSAID), traditional CV lipid risk factors, and

disease activity at 3 years. RESULTS: At 3 years, AA (as a proportion of AA

plus long-chain n-3 fatty acids that can compete with AA for cyclooxygenase

metabolism) was 30% lower in platelets and 40% lower in peripheral blood

mononuclear cells in subjects taking fish oil. Serum thromboxane B2 was 35%

lower and lipopolysaccharide-stimulated whole-blood prostaglandin E2 was 41%

lower with fish oil ingestion compared to no fish oil. NSAID use was reduced

by 75% from baseline with fish oil (p < 0.05) and by 37% without fish oil

(NS). Favorable changes in fasting blood lipids were seen with, but not

without fish oil. Remission at 3 years was more frequent with fish oil use

(72%) compared to no fish oil (31%).

CONCLUSION: Fish oil reduces cardiovascular risk in patients with RA through

multiple mechanisms.

PMID: 16881100

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6881100

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