Rheumatoid Arthritis: Omega-3 EPA Facilitates Remission

Omega-3 may be able to slow the progression of rheumatoid arthritis; each 1% increase in plasma EPA (eicosapentaenoic acid) concentration is associated with a 12% higher probability of disease remission.

This is the result of a study conducted by a group of researchers from the University of Adelaide (Australia) and published recently in the British Journal of Nutrition.

Rheumatoid Arthritis: an Autoimmune Disease That Can Lead to Disability

Rheumatoid arthritis (RA) is a chronic inflammatory disease that mainly affects the joints but can also involve other organs and tissues. The disease causes progressive damage to the joints at both bone and cartilage levels.

The resulting joint deformity leads to loss of functional capacity and ultimately disability. The cause of RA is unknown, but it is believed that various immune mechanisms are altered during the disease, inducing an autoimmune reaction and inflammation. Since there is no definitive cure, treatment aims to reduce symptoms and improve disability through appropriate and timely therapy.

Drugs targeting the inflammatory action of a molecule called tumor necrosis factor (TNF) have revolutionized rheumatoid arthritis treatment, and omega-3 fatty acids seem to play a role in this process. In fact, over 20 years ago, a study by Geusens and colleagues from the University of Pellenberg in Belgium showed that taking about 2.5 grams of omega-3 daily was associated with significant clinical benefits for patients, allowing them to reduce medication use.

Treatment with High Doses of Omega-3 Facilitates Disease Remission

In the Australian study, patients diagnosed with rheumatoid arthritis within the previous 12 months were selected. One group received a daily treatment with low doses of omega-3 consisting of 0.21 grams of EPA and 0.19 grams of DHA (docosahexaenoic acid), while another group was prescribed 3.2 grams of EPA and 2.3 grams of DHA per day.

The omega-3 concentrations in the blood were similar between the high- and low-dose groups, although the average concentrations were higher in the high-dose group. Analysis results showed that plasma EPA concentration correlated with remission time; a one-unit increase in EPA (1% of total fatty acids) was associated with a 12% higher probability of remission during the study period and with a reduction in pharmacological therapy failure. These results confirm data from a 2012 study analyzing 10 studies on RA patients, which showed reduced use of anti-inflammatory drugs in patients who took 2.7 grams of omega-3 daily for more than 3 months.

Omega-3 Protect Joint Health

The data obtained from this study highlight how omega-3s can protect joint health through their anti-inflammatory action. The results also emphasize, as the authors noted, that omega-3 biomarkers, particularly plasma EPA, could provide the ability to predict treatment outcomes in patients with rheumatoid arthritis.

Source: Proudman SM, Cleland LG, Metcalf RG, Sullivan TR, Spargo LD, James MJ. Plasma n-3 fatty acids and clinical outcomes in recent-onset rheumatoid arthritis. 2015 Br J Nutr doi: 10.1017/S0007114515002718 Other sources: Geusens P, Wouters C, Nijs J, Jiang Y, Dequeker J. Long-term effect of omega-3 fatty acid supplementation in active rheumatoid arthritis. 1994 Arthrit Rheumatol doi: 10.1002/art.1780370608 Lee Y-H, Bae S-C, Song G-G. Omega-3 polyunsaturated fatty acids and the treatment of rheumatoid arthritis: A meta-analysis. 2012 Arch Med Res doi: 10.1016/j.arcmed.2012.06.011