April 16, 2018
Summary
Supplementation with fish oil may be beneficial for some patients with rheumatoid arthritis (RA) due to its mild anti-inflammatory effects.1 The benefits that have been reported among this patient group include an improvement in pain and reduction in the use of non-steroidal anti-inflammatory drugs (NSAIDs).
Practice points
- Supplementation with omega-3 (n-3) polyunsaturated fatty acids (PUFAs) has been shown to improve pain and reduce NSAID use in some patients with RA.
- Studies suggest that an intake of 2.7 g/day of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) is required to achieve anti-inflammatory effects in patients with RA.
- Despite these reported symptomatic benefits, fish oil supplementation should not replace conventional therapy such as disease-modifying antirheumatic drugs (DMARDs).
RA is a chronic inflammatory autoimmune condition characterised by pain, swelling and destruction of the synovial joints resulting in disability.2 Although the exact cause of RA is unknown, symptoms are to some extent a result of local production of pro-inflammatory eicosanoids such as prostaglandin E2 and leukotriene B4.3
The aim of modern treatment strategies is to induce disease remission through early and aggressive use of DMARDs. These medicines are often used in combination with other therapies to reduce joint inflammation and destruction in patients with RA. Conventional synthetic DMARDs are the first-line treatment in RA, with methotrexate recommended as the gold standard.1
Despite the effectiveness of DMARDs, other therapies are routinely prescribed to help patients manage symptoms. These include NSAIDs and complementary therapies such as fish oil supplements.
