Veale D J, Torley H I, Richards I M, O'Dowd A, Fitzsimons C, Belch J J, Sturrock R D
University Department of Medicine, Ninewells Hospital and Medical School, Dundee.
Br J Rheumatol. 1994 Oct;33(10):954-8. doi: 10.1093/rheumatology/33.10.954.
Fish oil may be beneficial in the treatment of psoriasis and in RA. We examined the potential benefit of Efamol Marine, a combination of evening primrose oil and fish oil in the treatment of 38 patients with PsA. Patients with PsA were entered in a double-blind placebo controlled study and received either 12 Efamol Marine capsules or 12 placebo capsules daily for 9 months. All patients received placebo capsules for a further 3 months. At month 3 of the study patients were asked to reduce their intake of NSAIDs and maintain that decrease provided there was no worsening of their joint symptoms. Clinical assessments of skin and joint disease severity and activity were performed at 0, 1, 3, 6, 9 and 12 months. All measures of skin disease activity including severity, percentage body affected and itch were unchanged by Efamol Marine. The NSAID requirement remained the same between both treatment groups. In addition, there was no change demonstrated in the activity of arthritis as measured by duration of morning stiffness. Ritchie articular index, number of active joints, ESR and CRP. However, a rise in serum TXB2 was observed in the active group during the placebo phase; in addition a fall in leukotriene B4 production occurred during the active phase period followed by a marked rise during the placebo phase suggesting some laboratory documented anti-inflammatory effect. In conclusion, this study suggests that Efamol Marine may alter prostaglandin metabolism in patients with PsA, although it did not produce a clinical improvement and did not allow reduction in NSAID requirement. A larger dose of essential fatty acid may be needed to produce a clinical benefit.
鱼油可能对银屑病和类风湿性关节炎的治疗有益。我们研究了Efamol Marine（一种月见草油和鱼油的组合制剂）对38例银屑病关节炎（PsA）患者治疗的潜在益处。将PsA患者纳入一项双盲安慰剂对照研究，患者每天服用12粒Efamol Marine胶囊或12粒安慰剂胶囊，持续9个月。所有患者再服用3个月的安慰剂胶囊。在研究的第3个月，要求患者减少非甾体抗炎药（NSAIDs）的摄入量，并在关节症状未恶化的情况下维持减少的剂量。在第0、1、3、6、9和12个月对皮肤和关节疾病的严重程度及活动度进行临床评估。Efamol Marine未改变包括严重程度、身体受累百分比和瘙痒在内的所有皮肤病活动指标。两个治疗组之间NSAIDs的需求量保持不变。此外，通过晨僵持续时间、Ritchie关节指数、活动关节数量、血沉（ESR）和C反应蛋白（CRP）测量的关节炎活动度没有变化。然而，在安慰剂阶段，活性组观察到血清血栓素B2（TXB2）升高；此外，在活性治疗阶段白三烯B4生成减少，随后在安慰剂阶段显著升高，提示有一些实验室记录的抗炎作用。总之，本研究表明Efamol Marine可能改变PsA患者的前列腺素代谢，尽管它未产生临床改善，也未减少NSAIDs的需求量。可能需要更大剂量的必需脂肪酸才能产生临床益处。
