Comparison of the effect of omega-3 fatty acid supplementation with and without vitamin E in patients with rheumatoid arthritis

ABSTRACT

To test the hypothesis that an n-3 fatty acids [n-3] plus vitamin E supplementation is more effective than n-3 supplementation alone in improving the clinical, laboratory and inflammatory indices in patients with rheumatoid arthritis [RA]. A total of 55 RA patients [50 female, 5 male; mean age = 47 +/- 11y], in 3 groups, were included a double-blind randomized clinical trial. The groups were assigned to treatments as follows group 1 [G1], placebo [2 g/d MCT oil + vitamin E placebo]; group 2 [G2], n-3 fatty acids [1/2 g/d EPA/DHA] +vitamin E placebo; group 3 [G3], n-3 fatty acids [1/2 g/d EPA/DHA] + vitamin E [100 IU/d]. Clinical, inflammatory, and laboratory indicators were determined at the baseline and at the end of the 6the and 12th weeks. Intra- and inter-group comparisons of the values obtained were made using repeated measure-ANOVA and ANOVA, respectively [p<0.05]. In G2 and G3, improvements in clinical, biochemical, inflammation, and oxidative indicators, as well as in the score of health status assessment [by interview] were more pronounced than in G1 [P<0.01]. Also, compared to G1, at the end of week 12 there were higher improvements in morning stiffness and the score of health status assessment in G2 and G3 groups [P<0.05]. Combination of n-3 fatty acids with vitamin E improved most of the clinical and laboratory indices in RA patients. However, there were no significant differences between G2 and G3 other than decreased oxidation and ESR