Please use this identifier to cite or link to this item:
|Scopus||Web of Science®||Altmetric|
|Title:||Fish oil in recent onset rheumatoid arthritis: a randomised, double-blind controlled trial within algorithm-based drug use|
|Citation:||Annals of the Rheumatic Diseases, 2015; 74(1):89-95|
|Publisher:||BMJ Publishing Group|
|Susanna M Proudman, Michael J James, Llewellyn D Spargo, Robert G Metcalf, Thomas R Sullivan, Maureen Rischmueller, Katerina Flabouris, Mihir D Wechalekar, Anita T Lee, Leslie G Cleland|
|Abstract:||Background: The effects of fish oil (FO) in rheumatoid arthritis (RA) have not been examined in the context of contemporary treatment of early RA. This study examined the effects of high versus low dose FO in early RA employing a ‘treat-to-target’ protocol of combination disease-modifying anti-rheumatic drugs (DMARDs). Methods: Patients with RA <12 months’ duration and who were DMARD-naïve were enrolled and randomised 2:1 to FO at a high dose or low dose (for masking). These groups, designated FO and control, were given 5.5 or 0.4 g/day, respectively, of the omega-3 fats, eicosapentaenoic acid + docosahexaenoic acid. All patients received methotrexate (MTX), sulphasalazine and hydroxychloroquine, and DMARD doses were adjusted according to an algorithm taking disease activity and toxicity into account. DAS28-erythrocyte sedimentation rate, modified Health Assessment Questionnaire (mHAQ) and remission were assessed three monthly. The primary outcome measure was failure of triple DMARD therapy. Results: In the FO group, failure of triple DMARD therapy was lower (HR=0.28 (95% CI 0.12 to 0.63; p=0.002) unadjusted and 0.24 (95% CI 0.10 to 0.54; p=0.0006) following adjustment for smoking history, shared epitope and baseline anti–cyclic citrullinated peptide. The rate of first American College of Rheumatology (ACR) remission was significantly greater in the FO compared with the control group (HRs=2.17 (95% CI 1.07 to 4.42; p=0.03) unadjusted and 2.09 (95% CI 1.02 to 4.30; p=0.04) adjusted). There were no differences between groups in MTX dose, DAS28 or mHAQ scores, or adverse events. Conclusions: FO was associated with benefits additional to those achieved by combination ‘treat-to-target’ DMARDs with similar MTX use. These included reduced triple DMARD failure and a higher rate of ACR remission.|
|Keywords:||Humans; Arthritis, Rheumatoid; Sulfasalazine; Isoxazoles; Methotrexate; Hydroxychloroquine; Docosahexaenoic Acids; Eicosapentaenoic Acid; Fish Oils; Antirheumatic Agents; Blood Sedimentation; Treatment Outcome; Drug Therapy, Combination; Remission Induction; Double-Blind Method; Adult; Aged; Middle Aged; Female; Male; Early Medical Intervention|
|Description:||Published online September 30, 2013 in advance of the print journal.|
|Rights:||Copyright Article/author (or their employer) 2013.|
|Appears in Collections:||Medicine publications|
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.