Intake of ω-3 polyunsaturated fatty acids in patients with rheumatoid arthritis: A systematic review and meta-analysis

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#arthritis-rheumatoid #biomarkers #cardiovascular-diseases #fatty-acids-omega-3 #humans

Intake of ω-3 polyunsaturated fatty acids in patients with rheumatoid arthritis: A systematic review and meta-analysis

Gioxari et al., 2018 | Nutrition | Meta Analysis

Citation

Gioxari Aristea, Kaliora Andriana C, ... Panagiotakos Demosthenes P. Intake of ω-3 polyunsaturated fatty acids in patients with rheumatoid arthritis: A systematic review and meta-analysis. Nutrition. 2018-Jan;45:114-124.e4. doi:10.1016/j.nut.2017.06.023

Abstract

OBJECTIVES: Rheumatoid arthritis (RA) is a chronic, autoimmune inflammatory disease of multiple joints that puts the patient at high risk for developing cardiovascular diseases (CVDs). The aim of the present study was to conduct an up-to-date systematic review and meta-analysis of published randomized controlled trials (RCTs) to assess potential changes in RA disease activity, inflammation, and CVD risk after oral intake of ω-3 polyunsaturated fatty acids. METHODS: Publications up to July 31, 2016 were examined using the PubMed, SCOPUS, and EMBASE databases. INCLUSION CRITERIA: English language; human subjects; both sexes; RCTs; oral intake of ω-3 fatty acids; minimum duration of 3 mo; and no medication change throughout intervention. The Cochrane Risk of Bias tool was used to assess quality of trials. We included 20 RCTs, involving 717 patients with RA in the intervention group and 535 RA patients in the control group. RESULTS: Despite the evidence of overall low quality of trials, consumption of ω-3 fatty acids was found to significantly improve eight disease-activity-related markers. Regarding inflammation, only leukotriene B4 was reduced (five trials, standardized mean difference [SMD], -0.440; 95% confidence interval [CI], -0.676 to -0.205; I2 = 46.5%; P < 0.001). A significant amelioration was found for blood triacylglycerol levels (three trials, SMD, -0.316; 95% CI, -0.561 to -0.070; I2 = 0.0%; P = 0.012). CONCLUSION: The beneficial properties of ω-3 polyunsaturated fatty acids on RA disease activity confirm the results of previous meta-analyses. Among five proinflammatory markers evaluated, only leukotriene B4 was found to be reduced. However, a positive effect on blood lipid profile of patients with RA was evident, perhaps for the first time.

Key Findings

Despite the evidence of overall low quality of trials, consumption of ω-3 fatty acids was found to significantly improve eight disease-activity-related markers. Regarding inflammation, only leukotriene B4 was reduced (five trials, standardized mean difference [SMD], -0.440; 95% confidence interval [CI], -0.676 to -0.205; I2 = 46.5%; P < 0.001). A significant amelioration was found for blood triacylglycerol levels (three trials, SMD, -0.316; 95% CI, -0.561 to -0.070; I2 = 0.0%; P = 0.012).

Outcomes Measured

  • inflammatory markers

Population

Field Value
Population ra in the intervention
Sample Size 717
Age Range See abstract
Condition inflammation

MeSH Terms

  • Arthritis, Rheumatoid
  • Biomarkers
  • Cardiovascular Diseases
  • Fatty Acids, Omega-3
  • Humans
  • Leukotriene B4
  • Randomized Controlled Trials as Topic
  • Triglycerides

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: omega-3

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09