Omega-3 Fatty Acids Linked with Joint Health and Rheumatoid Arthritis
Every 1% increase in plasma phospholipid eicosapentaenoic acid (EPA) concentration (% of total fatty acids) is associated with a 12% increase in the probability of remission in rheumatoid arthritis, according to a new Br J Nutrition study.
The patients had been diagnosed with rheumatoid arthritis within the past 12 months. They were randomized to receive 3.2g EPA + 2.3 g docosahexaenoic acid (DHA) daily (high-dose) or 0.21 g EPA + 0.19g DHA daily (low-dose) and results are presented after 1 year. The media disease duration was 16 wk. As expected in nutrition studies, blood omega-3 concentrations overlapped between the high- and low-dose treatments although mean concentrations were higher in the high-dose group. There were no significant relationships between arachidonic acid/EPA and any of the outcome measures. EPA was the strongest mediator with outcomes but the relationship between DHA and time to American College of Rheumatology remission was similar to that of EPA.
This is not the first observation of a benefit with omega-3 fatty acids in patients with rheumatoid arthritis. Over 20 years ago, Geusens and colleagues reported that 2.6g omega-3 fatty acids daily was associated with significant clinical benefits among patients and reduced medication use.
A meta-analysis of 10 randomized, controlled trials (RCTs) involving 183 patients and 187 placebo-treated subjects found reduced NSAID consumption by individuals with rheumatoid arthritis consuming >2.7g omega-3 fatty acids daily for more than 3 months. Improvements in tender joint count, swollen joint count, morning stiffness, and physical function were reported but were not statistically significant (p<0.05).
Medications targeted to reduce the inflammatory actions of tumor necrosis factor (TNF) have revolutionized treatment of rheumatoid arthritis and omega-3 fatty acids seem to play a role in this pathway.
In conclusion, omega-3 fatty acids help support joint health.
Proudman SM, Cleland LG, Metcalf RG, Sullivan TR, Spargo LD, James MJ. Plasma n-3 fatty acids and clinical outcomes in recent-onset rheumatoid arthritis. 2015 Br J Nutr doi: 10.1017/S0007114515002718
Geusens P, Wouters C, Nijs J, Jiang Y, Dequeker J. Long-term effect of omega-3 fatty acid supplementation in active rheumatoid arthritits. 1994 Athrit Rheumatol doi: 10.1002/art.1780370608
Lee Y-H, Bae S-C, Song G-G. Omega-3 polyunsaturated fatty acids and the treatment of rheumatoid arthritis: A meta-analysis. 2012 Arch Med Res doi: 10.1016/j.arcmed.2012.06.011
Jeffery LE, Calder P, Filer A, Raza K, Buckley C, McInnes I, Taylor P, Fisher B. Plasma levels of polyunsaturated omega-3 eicosapentaenoic acid are associated with anti-TNF response in rheumatoid arthritis, and inhibit the etanercept driven rise in TH17 cell differentiation in vivo. 2015 Rheumatol doi: 10.1093/rheumatology/kev085.004