Effects of Fish oil Supplementation on Non-Steroidal Anti-Inflammatory Drug Requirements in Patients with Mild Rheumatoid Arthritis-A Double-Blind Placebo Controlled Study C.S. Lau

K.D. Morley and J.J.F. Belch

British Journal of Rheumatology. 1993. 32:982-989.

In this study, Omega-3 EPA and DHA relieves pain from rheumatoid arthritis Rheumatoid arthritis is a chronic inflammatory disease of the joints. There is no cure for the disease, and conventional treatments may only provide limited relief to the pain-stricken patient. In recent years, considerable attention has focussed on fish oil as a form of treatment for rheumatoid arthritis. The omega-3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) in fish oils are thought to provide the therapeutic benefit. Specifically, EPA and DHA may have anti-inflammatory properties.

Researchers examined whether a fish oil supplement could help reduce the requirement for antiinflammatory medication in patients with rheumatoid arthritis. They randomly assigned their 64 adult patients (45 females and 19 males) to receive 10 fish oil or placebo capsules per day for 12 months. (Fish oil contained 171mg EPA + 114mg DHA/capsule; the placebo was an air-filled capsule). Subjects were instructed to gradually reduce their dose of anti-inflammatory medication or NSAID (non-steroidal anti-inflammatory drug), starting at week 6, provided their symptoms did not worsen. At the end of the 12-month period, all patients were assigned to the placebo treatment for 3 months.

Patients receiving the fish oil experienced a significant reduction in NSAID use compared to the placebo group, with no worsening of the disease with respect to the clinical and lab tests used. At 3 months, the fish oil group’s average need for NSAIDs was reduced to 71.1% of the original dose, compared to the placebo group at 89.7%. At 12 months, this reduction reached its maximum, whereby the fish oil group’s need for NSAID dropped to 40.6% of the original dose, versus the placebo group’s 84.1%. This significant difference between the two groups continued even at 15 months, 3 months after the treatment had ended (44.7% in the fish oil group vs. 85.8% in the placebo group). Fifteen of the 29 subjects (52%) who took the fish oil felt their arthritis was better at the end of the trial compared to only 3 out of 23 (13%) from the placebo group. The researchers concluded that fish oil has anti-inflammatory properties similar to those of NSAIDs, when administered over a 1-year period, to patients with mild rheumatoid arthritis.