From the Department of Biomedical Engineering, University of Houston, Houston, TX.
J Clin Rheumatol. 2017 Sep;23(6):330-339. doi: 10.1097/RHU.0000000000000563.
Many clinical trials of omega-3 fatty acids, supplied as fish oil supplements, have been carried out in rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), lupus nephritis, and osteoarthritis (OA) over the past 3 decades. This review attempts to summarize the highlights of these studies to evaluate the clinical efficacy for omega-3 fatty acids to be added alongside existing treatment regimens. A total of 20 clinical trials have been carried out in RA, of which 16 exhibited significant improvements in multiple disease clinical outcomes. Nine clinical trials have been completed in SLE and lupus nephritis, of which 6 exhibited significant improvements in 1 or more clinical outcomes. A total of 4 clinical trials have been conducted in OA, of which 3 exhibited significant improvements in at least 1 clinical parameter. Multiple mechanisms for the clinical effects of omega-3 fatty acids have been implicated, including the modulation of eicosanoid synthesis toward a more anti-inflammatory profile and suppressed production of proinflammatory cytokines. Overall, fish oil supplements appear to be a safe and effective agent that could be added to the current treatment regimens in RA. Longer-term trials with larger patient cohort sizes are warranted to establish any long-term benefits of fish oil supplements in SLE, lupus nephritis, and OA.
在过去的 30 年中，许多临床试验已经在类风湿关节炎（RA）、系统性红斑狼疮（SLE）、狼疮性肾炎和骨关节炎（OA）中进行，这些试验使用鱼油补充剂来提供ω-3 脂肪酸。本综述试图总结这些研究的要点，以评估ω-3 脂肪酸在现有治疗方案基础上的临床疗效。在 RA 中进行了总共 20 项临床试验，其中 16 项在多种疾病临床结局方面显示出显著改善。在 SLE 和狼疮性肾炎中完成了 9 项临床试验，其中 6 项在 1 个或多个临床结局方面显示出显著改善。在 OA 中进行了总共 4 项临床试验，其中 3 项在至少 1 个临床参数方面显示出显著改善。ω-3 脂肪酸的临床作用的多种机制已经被涉及，包括对花生四烯酸合成的调节，向更具抗炎性的谱和抑制促炎细胞因子的产生。总的来说，鱼油补充剂似乎是一种安全有效的药物，可以添加到 RA 的当前治疗方案中。需要进行更长时间、更大患者队列规模的试验，以确定鱼油补充剂在 SLE、狼疮性肾炎和 OA 中的任何长期益处。
