Is body size a biomarker for optimizing dosing of omega-3 polyunsaturated fatty acids in the treatment of patients with IgA nephropathy?
Re-analysis of the North American IgA Nephropathy Study suggested that efficacy of omega-3 polyunsaturated fatty acids (omega-3 PUFA) was dosage-dependent on the basis of body size and plasma omega-3/omega-6 and eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratios. The objective of this study was to confirm these assertions. Data from a previously reported randomized 2-yr clinical trial in which two dosages of an ethyl ester omega-3 PUFA (Omacor) were given to 73 high-risk patients with IgA nephropathy were reviewed. Omacor also was used in the North American IgA Nephropathy Study. Parameters included body weight; body mass index (BMI); plasma phospholipid AA, EPA, and docosahexanoic acid (DHA) levels and serum creatinine and 24-h urine protein (UP) levels during the 2-yr trial; and time to ESRD after 6.4 yr. Plasma phospholipid levels of EPA, DHA, and EPA/AA ratios were significantly inversely correlated with increasing body weight and BMI in the Omacor 4-g dosage group but not in the Omacor 8-g dosage group. Conversely, increasing levels of lipid parameters were observed with increasing dosages of Omacor (EPA+DHA) in grams per kilogram of body weight at 6 wk of treatment. None of the plasma omega-3 PUFA levels, EPA/AA ratios, or Omacor dosage per kilogram was significantly associated with reciprocal serum creatinine or UP slopes during the 2-yr trial or with ESRD. This post hoc analysis of body weight and BMI, plasma omega-3 PUFA status, and renal outcome did not find that treatment efficacy of omega-3 PUFA was dosage dependent on the basis of body size.
Donadio
James V
JV
Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA. donadio.james@mayo.edu
Bergstralh
Eric J
EJ
Bibus
Douglas M
DM
Grande
Joseph P
JP
D016718:Arachidonic Acid / Q000097:blood; D015992:Body Mass Index; D049628:Body Size; D001835:Body Weight; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D004281:Docosahexaenoic Acids / Q000008:administration & dosage* / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage* / Q000097:blood; D005922:Glomerulonephritis, IGA / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D010743:Phospholipids / Q000097:blood; D016016:Proportional Hazards Models; D011507:Proteinuria / Q000097:blood / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome
D004338:Drug Combinations; D010743:Phospholipids; D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid; D015118:Eicosapentaenoic Acid; D003404:Creatinine; C405603:Omacor