Zurier R B, Rossetti R G, Jacobson E W, DeMarco D M, Liu N Y, Temming J E, White B M, Laposata M
University of Massachusetts Medical Center, Worcester 01655-0335, USA.
Arthritis Rheum. 1996 Nov;39(11):1808-17. doi: 10.1002/art.1780391106.
To assess the clinical efficacy and adverse effects of gamma-linolenic acid (GLA), a plant seed oil-derived unsaturated fatty acid that suppresses inflammation and joint tissue injury in animal models, in the treatment of active rheumatoid arthritis (RA).
Fifty-six patients with active RA were randomized to treatment groups in a 6-month, double-blind trial of GLA versus placebo. This was followed by a 6-month, single-blind trial during which all patients received GLA. Patients were treated with 2.8 gm/day of GLA as the free fatty acid or with sunflower seed oil (placebo) administered in identical capsules.
Treatment with GLA for 6 months resulted in statistically significant and clinically relevant reductions in the signs and symptoms of disease activity in patients with RA. Overall meaningful responses (at least 25% improvement in 4 measures) were also better in the GLA treatment group (14 of 22 patients versus 4 of 19 in the placebo group; P = 0.015). During the second 6 months, both groups exhibited improvement in disease activity. Thus, patients taking GLA during the entire study showed progressive improvement during the second 6 months. In this group, 16 of 21 patients showed meaningful improvement at 12 months compared with study entry.
GLA at doses used in this study is a well-tolerated and effective treatment for active RA. GLA is available as a component of several plant seed oils and is usually taken in far lower doses than were used in this trial. It is not approved in the United States for the treatment of any condition, and should not be viewed as therapy for any disease. Further controlled studies of its in RA are warranted.
评估γ-亚麻酸(GLA)治疗活动性类风湿关节炎(RA)的临床疗效及不良反应。GLA是一种源自植物种子油的不饱和脂肪酸,在动物模型中可抑制炎症和关节组织损伤。
56例活动性RA患者被随机分为治疗组,进行为期6个月的GLA与安慰剂双盲试验。随后进行为期6个月的单盲试验,在此期间所有患者均接受GLA治疗。患者接受2.8克/天的游离脂肪酸形式的GLA治疗,或服用装在相同胶囊中的葵花籽油(安慰剂)。
GLA治疗6个月后,RA患者疾病活动的体征和症状在统计学上有显著且临床相关的减轻。GLA治疗组的总体有意义反应(4项指标至少改善25%)也更好(22例患者中的14例,而安慰剂组19例患者中的4例;P = 0.015)。在第二个6个月期间,两组疾病活动均有改善。因此,在整个研究期间服用GLA的患者在第二个6个月期间显示出逐渐改善。在该组中,21例患者中有16例在12个月时与研究开始时相比有有意义的改善。
本研究中使用的剂量的GLA是治疗活动性RA的耐受性良好且有效的疗法。GLA是几种植物种子油的成分之一,通常服用的剂量远低于本试验中使用的剂量。在美国,它未被批准用于治疗任何病症,不应被视为任何疾病的疗法。有必要对其在RA中的应用进行进一步的对照研究。