Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose
Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting the synovial joints, often with a progressive and destructive course, leading to disability. Nowadays, there are several drugs available to treat this condition. However, in some patients the disease can be quite difficult to manage, due to refractoriness and expense of therapy. Complimentary therapies to manage RA may contribute to this unmet need. The anti-inflammatory effect of the Mediterranean diet (MedDiet) has been increasingly recognized in the last forty years together with the anti-inflammatory properties of omega-3 fatty acids (n-3 FA) [1,2].
This study aimed to evaluate the effects of n-3 FA supplements and MedDiet upon disease activity and laboratory measures of a cohort of RA patients.
Methods
This is a prospective randomized controlled trial including 37 RA patients (fulfilling ACR 1987 classification criteria). Patients were assigned to n-3 FA supplements (n=11) or MedDiet (n=8) and compared to a control group (n=15), during a 6 month follow-up period. Demographic characteristics, number of tender and swollen joints, global health status, ESR, CRP, and DAS-28 were obtained before and after the intervention. The analysis of dietary intake was performed with a semi-quantitative food frequency questionnaire. Patients were further stratified according to biological therapy. The statistical analysis was performed by Wilcoxon and Kruskal-Wallis tests with a significance level of 0,05.
Results
A significant reduction in ESR was noted after 6 months of n-3 FA but there was no significant variation in the remaining measures after 6 months, independently of the study group and the ongoing therapy for RA. However, a trend towards a reduction in DAS-28 and VAS was noted (table 1).
|
Table 1 – Evaluated parameters at the beginning and after 6 months of intervention. |
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|
|
n-3 FA |
MedDiet |
Control Group |
p |
|||||||||
|
Parameter |
Beginning |
6 months |
n |
p |
Beginning |
6 months |
n |
p |
Beginning |
6 months |
n |
p |
|
|
ESR |
32,18 ± 19,42 |
19,64 ± 13,27 |
11 |
0,01 |
21,75 ± 17,32 |
24,75 ± 13,72 |
8 |
0,58 |
28,00 ± 21,03 |
22,13 ± 12,02 |
15 |
0,12 |
> 0,05 |
|
DAS-28 |
3,65 ± 1,26 |
3,41 ± 1,10 |
11 |
0,76 |
3,30 ± 1,02 |
3,53 ± 1,65 |
8 |
0,55 |
3,58 ± 0,91 |
3,94 ± 1,13 |
15 |
0,36 |
> 0,05 |
|
EVA GH |
39,09 ± 26,16 |
38,18 ± 29,17 |
11 |
0,84 |
46,25 ± 17,68 |
43,75 ± 22,80 |
8 |
0,94 |
46,67 ± 26,10 |
51,00 ± 28,55 |
15 |
0,36 |
> 0,05 |
|
Tender Joints |
3,54 ± 6,29 |
3,82 ± 5,51 |
11 |
0,73 |
3,00 ± 5,24 |
4,12 ± 5,03 |
8 |
0,13 |
2,33 ± 3,27 |
4,40 ± 5,18 |
15 |
0,10 |
> 0,05 |
|
Swollen Joints |
1,45 ± 2,50 |
1,00 ± 1,79 |
11 |
0,44 |
0,25 ± 0,46 |
1,12 ± 1,88 |
8 |
0,25 |
0,53 ± 0,83 |
1,13 ± 2,06 |
15 |
0,25 |
> 0,05 |
|
CRP |
0,14 ± 0,10 |
0,31 ± 0,40 |
6 |
1,00 |
0,45 ± 0,45 |
1,50 ± 2,35 |
5 |
0,13 |
0,82 ± 1,21 |
0,70 ± 0,41 |
9 |
0,16 |
> 0,05 |
|
Mean ± standard deviation; n,number of patients. |
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Conclusion
Omega-3 fatty acids supplements were associated with a reduction in the ESR after 6 months in accordance to other studies. The trend towards a reduction in DAS-28 observed in this study encourages the need for further studies in larger samples.
1. Serra-Majem, L., B. Roman, and R. Estruch, Scientific evidence of interventions using the Mediterranean diet: a systematic review. Nutr Rev, 2006. 64(2 Pt 2): p. S27-47.
2. Calder, P.C., Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology? Br J Clin Pharmacol, 2013. 75(3): p. 645-62.
Disclosure:
A. C. Araújo,
None;
M. F. Moraes-Fontes,
None;
L. Santos,
None;
N. Riso,
None.
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