Impact of type and dose of oral polyunsaturated fatty acid supplementation on disease activity in inflammatory rheumatic diseases: a systematic literature review and meta-analysis.
Inflammatory rheumatic diseases
Meta-analysis
Omega-3
Omega-6
Polyunsaturated fatty acids
Rheumatoid arthritis
Systematic literature review
Journal
Arthritis research & therapy
ISSN: 1478-6362
Titre abrégé: Arthritis Res Ther
Pays: England
ID NLM: 101154438
Informations de publication
Date de publication:
07 05 2022
07 05 2022
Historique:
received:
02
11
2021
accepted:
19
04
2022
entrez:
7
5
2022
pubmed:
8
5
2022
medline:
11
5
2022
Statut:
epublish
Résumé
Polyunsaturated fatty acid (PUFA) supplementation has been reported to improve disease activity in inflammatory rheumatic diseases (IRDs). However, data are often conflicting and studies insufficiently large to draw conclusions. This systematic literature review and meta-analysis aimed to better estimate the effect of oral supplementation with omega (n)-3 and n-6 PUFA on IRD activity in terms of duration, dose, type, and source. The literature was searched in PubMed, EMBASE, and Cochrane Library databases up to October 2020. Studies were reviewed in accordance with PRISMA guidelines. The effect of PUFA supplementation on disease activity was expressed as the standardized mean difference (95% CI). Metaregression and subgroup analyses involved type of IRD, Jadad score, PUFA source (animal or vegetable), and doses. We obtained 42 references; 30 randomized controlled studies were included comparing the effects of PUFA versus control on disease activity (710 IRD patients receiving PUFA supplementation and 710 controls, most with rheumatoid arthritis). We found a significant improvement in pain, swollen and tender joint count, Disease Activity Score in 28 joints, and Health Assessment Questionnaire score in IRD patients receiving PUFA supplementation as compared with controls, with a significant decrease in erythrocyte sedimentation rate but not C-reactive protein level. Although meta-regression revealed no difference by IRD type or source or dose of PUFA supplementation, subgroup analysis revealed more parameters significantly improved with animal- than vegetable-derived PUFAs and 3- to 6-month supplementation. Most studies examined high-dose supplementation (>2 g/day). PUFA consumption, especially omega-3 from animal source >2 g/day, may improve IRD activity and might be an adjuvant therapy in rheumatoid arthritis. The protocol was registered at PROSPERO ( CRD42021253685 ).
Sections du résumé
BACKGROUND
Polyunsaturated fatty acid (PUFA) supplementation has been reported to improve disease activity in inflammatory rheumatic diseases (IRDs). However, data are often conflicting and studies insufficiently large to draw conclusions. This systematic literature review and meta-analysis aimed to better estimate the effect of oral supplementation with omega (n)-3 and n-6 PUFA on IRD activity in terms of duration, dose, type, and source.
METHODS
The literature was searched in PubMed, EMBASE, and Cochrane Library databases up to October 2020. Studies were reviewed in accordance with PRISMA guidelines. The effect of PUFA supplementation on disease activity was expressed as the standardized mean difference (95% CI). Metaregression and subgroup analyses involved type of IRD, Jadad score, PUFA source (animal or vegetable), and doses.
RESULTS
We obtained 42 references; 30 randomized controlled studies were included comparing the effects of PUFA versus control on disease activity (710 IRD patients receiving PUFA supplementation and 710 controls, most with rheumatoid arthritis). We found a significant improvement in pain, swollen and tender joint count, Disease Activity Score in 28 joints, and Health Assessment Questionnaire score in IRD patients receiving PUFA supplementation as compared with controls, with a significant decrease in erythrocyte sedimentation rate but not C-reactive protein level. Although meta-regression revealed no difference by IRD type or source or dose of PUFA supplementation, subgroup analysis revealed more parameters significantly improved with animal- than vegetable-derived PUFAs and 3- to 6-month supplementation. Most studies examined high-dose supplementation (>2 g/day).
CONCLUSION
PUFA consumption, especially omega-3 from animal source >2 g/day, may improve IRD activity and might be an adjuvant therapy in rheumatoid arthritis.
TRIAL REGISTRATION
The protocol was registered at PROSPERO ( CRD42021253685 ).
Identifiants
pubmed: 35526074
doi: 10.1186/s13075-022-02781-2
pii: 10.1186/s13075-022-02781-2
pmc: PMC9077862
doi:
Substances chimiques
Fatty Acids, Omega-3
0
Fatty Acids, Unsaturated
0
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
100Informations de copyright
© 2022. The Author(s).
Références
Br J Rheumatol. 1994 Oct;33(10):954-8
pubmed: 7921757
Ann Intern Med. 1993 Nov 1;119(9):867-73
pubmed: 8214997
Nutrition. 2005 Feb;21(2):131-6
pubmed: 15723739
Exp Neurol. 2005 Jan;191(1):119-27
pubmed: 15589518
Arthritis Rheum. 1994 Jun;37(6):824-9
pubmed: 8003055
Rheumatol Int. 2016 May;36(5):685-95
pubmed: 26746843
Bangladesh Med Res Counc Bull. 2009 Aug;35(2):63-8
pubmed: 20120782
N Engl J Med. 2019 Jan 3;380(1):11-22
pubmed: 30415628
Nutrition. 2018 Jan;45:114-124.e4
pubmed: 28965775
Int J Rheum Dis. 2012 Aug;15(4):380-9
pubmed: 22898218
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
Scand J Rheumatol. 2018 Jan;47(1):27-36
pubmed: 28303758
Br J Rheumatol. 1991 Oct;30(5):370-2
pubmed: 1913008
Nat Rev Rheumatol. 2018 Feb;14(2):71-72
pubmed: 29323341
Heart. 2021 Jan;107(2):150-158
pubmed: 32820013
Scand J Rheumatol. 1992;21(4):178-85
pubmed: 1529284
Clin Biochem. 2010 Apr;43(6):576-80
pubmed: 20034487
Arthritis Rheum. 1995 Aug;38(8):1107-14
pubmed: 7639807
Joint Bone Spine. 2022 Mar;89(2):105319
pubmed: 34902577
Nutrients. 2017 Mar 25;9(4):
pubmed: 28346333
Lipids Health Dis. 2011 Aug 04;10:130
pubmed: 21816071
Clin Dev Immunol. 2004 Mar;11(1):13-21
pubmed: 15154607
Nutrients. 2021 Feb 26;13(3):
pubmed: 33652915
Lancet. 1985 Jan 26;1(8422):184-7
pubmed: 2857265
J Rheumatol. 2006 Feb;33(2):307-10
pubmed: 16465662
Rheumatology (Oxford). 2008 May;47(5):665-9
pubmed: 18362100
Rheumatol Int. 1995;14(6):231-4
pubmed: 7597378
J Clin Epidemiol. 1995 Nov;48(11):1379-90
pubmed: 7490601
Clin Nutr. 2018 Apr;37(2):494-504
pubmed: 28302406
FASEB J. 2019 Feb;33(2):1536-1539
pubmed: 30703872
J Nutr Biochem. 2013 Jul;24(7):1367-72
pubmed: 23333088
Arthritis Rheumatol. 2021 Jan;73(1):69-77
pubmed: 32909390
Scand J Rheumatol. 2006 Sep-Oct;35(5):359-62
pubmed: 17062435
Arch Med Res. 2012 Jul;43(5):356-62
pubmed: 22835600
Arthritis Rheum. 1996 Nov;39(11):1808-17
pubmed: 8912502
Nutrients. 2017 Jan 06;9(1):
pubmed: 28067815
Ann Rheum Dis. 1992 Jul;51(7):877-80
pubmed: 1632662
Arthritis Rheum. 1990 Sep;33(9):1416-9
pubmed: 2206140
Nutrients. 2020 Nov 14;12(11):
pubmed: 33202579
Ann Rheum Dis. 2009 Nov;68(11):1680-5
pubmed: 19054825
Pain. 2007 May;129(1-2):210-23
pubmed: 17335973
Br J Nutr. 2009 May;101(10):1517-26
pubmed: 19245735
J Rheumatol. 1988 Oct;15(10):1471-5
pubmed: 2849682
J Int Med Res. 2004 Sep-Oct;32(5):443-54
pubmed: 15458276
Arthritis Rheum. 1990 Jun;33(6):810-20
pubmed: 2363736
JAMA. 2020 Dec 8;324(22):2268-2280
pubmed: 33190147
Eur J Clin Invest. 1992 Oct;22(10):687-91
pubmed: 1459173
Prog Lipid Res. 2008 Mar;47(2):147-55
pubmed: 18198131
J Rheumatol. 2000 Oct;27(10):2343-6
pubmed: 11036827
J Nutr. 1997 Aug;127(8):1435-44
pubmed: 9237935
Int J Mol Sci. 2019 Oct 11;20(20):
pubmed: 31614433
Psychol Bull. 1992 Jul;112(1):155-9
pubmed: 19565683
BMJ. 2003 Sep 6;327(7414):557-60
pubmed: 12958120