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A randomised interventional trial of omega-3-polyunsaturated fatty acids on endothelial function and disease activity in systemic lupus erythematosus
S A Wright 1,2,3, F M O'Prey 1, M T McHenry 2,3, W J Leahey 1, A B Devine 1, E M Duffy 2,4, D G Johnston 1, M B Finch 2,3, A L Bell 2,3, G E McVeigh 1
1 Department of Therapeutics and Pharmacology, Queens University Belfast, Belfast, Northern Ireland, UK
2 Lupus Research Group, Queens University Belfast, Belfast, Northern Ireland, UK
3 Department of Rheumatology, Musgrave Park Hospital, Belfast, Northern Ireland, UK
4 Northern Ireland Centre for Food and Health (NICHE), Department of Biomedical Sciences, University of Ulster, Northern Ireland, UK
Correspondence to: Dr Stephen Wright, Department of Rheumatology, Musgrave Park Hospital, Belfast BT9 7JB, Northern Ireland, UK; drsawright@yahoo.co.uk
Objective: To determine the clinical effect of dietary supplementation with low-dose omega-3-polyunsaturated fatty acids on disease activity and endothelial function in patients with systemic lupus erythematosus.
Methods: A 24-week randomised double-blind placebo-controlled parallel trial of the effect of 3 g of omega-3-polyunsaturated fatty acids on 60 patients with systemic lupus erythematosus was performed. Serial measurements of disease activity using the revised Systemic Lupus Activity Measure (SLAM-R) and British Isles Lupus Assessment Group index of disease activity for systemic lupus erythematosus (BILAG), endothelial function using flow-mediated dilation (FMD) of the brachial artery, oxidative stress using platelet 8-isoprostanes and analysis of platelet membrane fatty acids were taken at baseline, 12 and 24 weeks.
Results: In the fish oil group there was a significant improvement at 24 weeks in SLAM-R (from 9.4 (SD 3.0) to 6.3 (2.5), p<0.001); in BILAG (from 13.6 (6.0) to 6.7 (3.8), p<0.001); in FMD (from 3.0% (–0.5 to 8.2) to 8.9% (1.3 to 16.9), p<0.001) and in platelet 8-isoprostanes (from 177 pg/mg protein (23–387) to 90 pg/mg protein (32–182), p = 0.007).
Conclusions: Low-dose dietary supplementation with omega-3 fish oils in systemic lupus erythematosus not only has a therapeutic effect on disease activity but also improves endothelial function and reduces oxidative stress and may therefore confer cardiovascular benefits.
Copyright © 2008 BMJ Publishing Group Ltd & European League Against Rheumatism
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