A randomised interventional trial of omega-3-polyunsaturated fatty acids on endothelial function and disease activity in systemic lupus erythematosus.
OBJECTIVE
To determine the clinical effect of dietary supplementation with low-dose omega-3-polyunsaturated fatty acids on disease activity and endothelial function in patients with systemic lupus erythematosus.


METHODS
A 24-week randomised double-blind placebo-controlled parallel trial of the effect of 3 g of omega-3-polyunsaturated fatty acids on 60 patients with systemic lupus erythematosus was performed. Serial measurements of disease activity using the revised Systemic Lupus Activity Measure (SLAM-R) and British Isles Lupus Assessment Group index of disease activity for systemic lupus erythematosus (BILAG), endothelial function using flow-mediated dilation (FMD) of the brachial artery, oxidative stress using platelet 8-isoprostanes and analysis of platelet membrane fatty acids were taken at baseline, 12 and 24 weeks.


RESULTS
In the fish oil group there was a significant improvement at 24 weeks in SLAM-R (from 9.4 (SD 3.0) to 6.3 (2.5), p<0.001); in BILAG (from 13.6 (6.0) to 6.7 (3.8), p<0.001); in FMD (from 3.0% (-0.5 to 8.2) to 8.9% (1.3 to 16.9), p<0.001) and in platelet 8-isoprostanes (from 177 pg/mg protein (23-387) to 90 pg/mg protein (32-182), p = 0.007).


CONCLUSIONS
Low-dose dietary supplementation with omega-3 fish oils in systemic lupus erythematosus not only has a therapeutic effect on disease activity but also improves endothelial function and reduces oxidative stress and may therefore confer cardiovascular benefits.
Wright
S A
SA
Department of Therapeutics and Pharmacology, Queens University Belfast, Belfast, Northern Ireland, UK. drsawright@yahoo.co.uk
O'Prey
F M
FM
McHenry
M T
MT
Leahey
W J
WJ
Devine
A B
AB
Duffy
E M
EM
Johnston
D G
DG
Finch
M B
MB
Bell
A L
AL
McVeigh
G E
GE
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D002462:Cell Membrane / Q000737:chemistry; D019587:Dietary Supplements; D015237:Dinoprost / Q000031:analogs & derivatives / Q000097:blood; D004281:Docosahexaenoic Acids / Q000032:analysis; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid; D004730:Endothelium, Vascular / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005231:Fatty Acids, Unsaturated / Q000032:analysis; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin; D012039:Regional Blood Flow; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D018617:Ultrasonography, Doppler, Pulsed; D014664:Vasodilation; D014665:Vasodilator Agents
D015415:Biomarkers; D015525:Fatty Acids, Omega-3; D005231:Fatty Acids, Unsaturated; D014665:Vasodilator Agents; D004281:Docosahexaenoic Acids; C075750:8-epi-prostaglandin F2alpha; D015118:Eicosapentaenoic Acid; D015237:Dinoprost; D005996:Nitroglycerin