Impact of type and dose of oral polyunsaturated fatty acid supplementation on disease activity in inflammatory rheumatic diseases: a systematic literature review and meta-analysis

What this study found

PUFA supplementation significantly improved disease activity across inflammatory rheumatic diseases, including pain, tender and swollen joint counts, DAS28, and HAQ, with ESR decreased but CRP often unchanged. In RA, animal-source omega-3s and higher doses (>2 g/day) produced broader improvements (TJC, VAS activity, morning stiffness, DAS28, HAQ, ESR) than vegetable sources; improvements generally appeared after at least 3 months (no significant changes at 1 month). 6-month data supported ongoing benefits. Adverse events were mostly mild GI issues; no serious events reported. Conclusion:…

Study & population

Systematic review and meta-analysis of randomized controlled trials in adults with inflammatory rheumatic diseases (primarily rheumatoid arthritis; some ankylosing spondylitis and psoriatic arthritis).

Intervention

Oral PUFA supplementation (n-3 and/or n-6 fatty acids) with sources including fish oil, cod liver oil, seal oil, evening primrose oil, flaxseed oil, mussel oil, and microalgae-derived DHA.

Key limitation

Small per-trial sample sizes; substantial heterogeneity in PUFA type/source/dose/duration and comparators; majority of data from RA; limited data for AS and PsA; potential publication bias; varied methodological quality (median Jadad score 3; only 30 of 42 studies in meta-analysis had Jadad ≥4).

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