title: Marine Oil Supplements for Arthritis Pain: A Systematic Review and Meta-Analysis of Randomized Trials.
abstract: Arthritis patients often take fish oil supplements to alleviate symptoms, but limited evidence exists regarding their efficacy. The objective was to evaluate whether marine oil supplements reduce pain and/or improve other clinical outcomes in patients with arthritis. Six databases were searched systematically (24 February 2015). We included randomized trials of oral supplements of all marine oils compared with a control in arthritis patients. The internal validity was assessed using the Cochrane Risk of Bias tool and heterogeneity was explored using restricted maximum of likelihood (REML)-based meta-regression analysis. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to rate the overall quality of the evidence. Forty-two trials were included; 30 trials reported complete data on pain. The standardized mean difference (SMD) suggested a favorable effect (-0.24; 95% confidence interval, CI, -0.42 to -0.07; heterogeneity,I² = 63%. A significant effect was found in patients with rheumatoid arthritis (22 trials; -0.21; 95% CI, -0.42 to -0.004) and other or mixed diagnoses (3 trials; -0.63; 95% CI, -1.20 to -0.06), but not in osteoarthritis patients (5 trials; -0.17; 95% CI, -0.57-0.24). The evidence for using marine oil to alleviate pain in arthritis patients was overall of low quality, but of moderate quality in rheumatoid arthritis patients.
authors.affiliation: Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Copenhagen F, Denmark. ninnaks@hotmail.com.|Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 FC Copenhagen, Denmark. ninnaks@hotmail.com.
authors.forename: Ninna K
authors.initials: NK
authors.lastname: Senftleber
authors.affiliation: Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Copenhagen F, Denmark. sabrina.mai.nielsen@regionh.dk.|Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 FC Copenhagen, Denmark. sabrina.mai.nielsen@regionh.dk.
authors.forename: Sabrina M
authors.initials: SM
authors.lastname: Nielsen
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 FC Copenhagen, Denmark. jra@nexs.ku.dk.
authors.forename: Jens R
authors.initials: JR
authors.lastname: Andersen
authors.affiliation: Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Copenhagen F, Denmark. henning.bliddal@regionh.dk.
authors.forename: Henning
authors.initials: H
authors.lastname: Bliddal
authors.affiliation: Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Copenhagen F, Denmark. simon.tarp@regionh.dk.
authors.forename: Simon
authors.initials: S
authors.lastname: Tarp
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 FC Copenhagen, Denmark. ll@nexs.ku.dk.
authors.forename: Lotte
authors.initials: L
authors.lastname: Lauritzen
authors.affiliation: Division of Rheumatology, University of California, Los Angeles, CA 90095, USA. defurst@mednet.ucla.edu.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Furst
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. msalmazor@mdanderson.org.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Suarez-Almazor
authors.affiliation: Musculoskeletal Group, Cochrane Collaboration, Ottawa, ON K1H 8L6, Canada. lyddiatt@lyddiatt.ca.
authors.forename: Anne
authors.initials: A
authors.lastname: Lyddiatt
authors.affiliation: Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Copenhagen F, Denmark. robin.christensen@regionh.dk.
authors.forename: Robin
authors.initials: R
authors.lastname: Christensen
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D016208:Databases, Factual; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000494:pharmacology*; D015118:Eicosapentaenoic Acid / Q000494:pharmacology*; D005395:Fish Oils / Q000494:pharmacology*; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D010003:Osteoarthritis / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D017962:alpha-Linolenic Acid / Q000494:pharmacology*
chemical_list: D005395:Fish Oils; D017962:alpha-Linolenic Acid; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid
keywords: arthritis; complementary medicine; fish oil; joint pain; marine oil; meta-analysis; randomized controlled trials; rheumatology