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dyslimbic
04-09-2008, 07:22 AM
http://www.sciencedaily.com/releases/2008/04/080408163252.htm

Omega-3 Does Not Prevent Relapse Of Crohn's Disease, Study Suggests

ScienceDaily (Apr. 8, 2008) — An international study led by Dr. Brian Feagan of Robarts Research Institute at The University of Western Ontario in London, Canada has found that omega-3 fatty acids are ineffective for managing Crohn's disease.
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Effective therapy to maintain remission in Crohn disease (a chronic inflammatory disease primarily involving the small and large intestine) is an unmet medical need, with the use of some immunosuppressive drugs associated with an increased risk of infection.

"A significant amount of time and money is spent annually on alternative therapies such as Omega-3 fatty acids, without strong evidence that they are beneficial to patients with inflammatory bowel disease," says gastroenterologist Dr. Feagan, who is Director of Robarts Clinical Trials and lead author on the study. "I encourage Crohn's patients to focus on prescription medications that we know are effective for preventing relapse of disease, such as azathioprine, methotrexate, and TNF blockers."

Found in fatty fish such as salmon, mackerel, herring and sardines, omega-3 fatty acids have an anti-inflammatory effect and are therefore used in the treatment of inflammatory disorders such as rheumatoid arthritis and IgA nephropathy (a kidney disease).

The widespread belief among patients and health care providers that omega-3 fatty acids are effective treatment for inflammatory bowel disease may have stemmed from a relatively small Italian research study, published in 1996 in the New England Journal of Medicine, which found a benefit for preventing relapse of Crohn's disease.

"Small, single centre clinical trials often overestimate the true effects of treatment" says Dr. Feagan. "That's why it is important to conduct large-scale, randomized, multi-centre studies in order to confirm preliminary results."

Feagan's study includes two large-scale trials involving 738 Crohn's patients (ten times the number of patients involved in the original New England study) at clinical centres in Europe, Israel, Canada, and the United States from January 2003 to February 2007. Both trials demonstrated that the omega-3 fatty acid formulation offered no benefit in preventing relapse in Crohn's disease. However, patients who took the omega-3 fatty acid preparation did have significantly lower concentrations of triglycerides, a high level of which is a risk factor for heart disease.

Journal reference: JAMA. 2008;299[14]:1690-1697

Adapted from materials provided by University of Western Ontario, via EurekAlert!, a service of AAAS.

Ted Hutchinson
04-09-2008, 08:46 AM
Review article: the evidence base for interventions used to maintain remission in Crohn’s disease (http://www.ncbi.nlm.nih.gov/pubmed/17919275)
Four small placebo-controlled trials were included in this review.15 As shown in Figure 3 (top graph), meta-analysis of data from all the four studies did not show a statistically significant beneficial effect for omega-3 (RR 0.64, 95% CI 0.40 to 1.04). However, as shown in the bottom graph of Figure 3, when the authors performed a sensitivity analysis using only data from three of the four studies that had used enteric-coated omega-3 fatty acid preparations, a statistically significant beneficial effect of omega-3 fatty acids was demonstrated (RR 0.49, 95% CI 0.35 to 0.69). It appears from these results that daily oral therapy with enteric coated omega-3 may be effective for the maintenance of remission in CD, but again, the small sample sizes of the primary studies do not allow any firm conclusions to be made. I understand that two large studies on omega-3 fatty acids involving about 760 participants have recently been completed, but the results of these are not yet available (John McDonald, personal communication).

I would like to see trials of omega 3 done on people who have had their Vitamin D status raised to optimal 125-150nmol/l 50-60ng/ml. At the moment most people are vitamin d insufficient. Vit d is an excellent anti inflammatory agent using both omega 3 and Vitamin d3 at the same time will improve the impact of both.