For Crohn’s Patients, Omega-3 Fatty Acids Not Effective In Preventing Relapse
April 9th, 2008 | by admin |Administrationof omega-3 fatty acid supplements did not appear to improve the rate ofrelapse in patients with Crohn’s disease, according to a study releasedon April 9, 2008 in JAMA.
Crohn’sDisease is a gastrointestinal disorder which is indicated bychronicinflammation of the wall of the digestive tract, usually in the ileumor large intestines. The disease involves constant cycles of flare-upsandremission throughout the life of the patient, and without propertreatment, must be addressed surgically. It is considered aninflammatory bowel disease (IBD), similar to ulcerative colitis.Therapy to induce remission in Crohn’s disease is an unmet medicalneed, usually attempted with the use of certain immunosuppressivedrugs, which are associated with infection and other risks. ManyCrohn’s patients turn to alternative medications in the face ofdisappointing overall results.
Omega-3fatty acids unsaturated fatty acids usually found in marine fish. Theyhave anti-inflammatory properties, and have been used to treat someinflammatory disorders such as rheumatoid arthritis. Earlier studieshave evalued omega-3 fatty acids for the maintenance of remission inCrohn’s disease, but have had inconsistent results.
To attemptto rectify this, Brian G. Feagan, M.D., of the Robarts ResearchInstitute, University of Western Ontario, London, Ontario, andcolleagues performed two large trials of high-dose omega-3 free fattyacids as therapy in Crohn’s patients who were in remission. Thestudies, called the Epanova Program in Crohn’s Study 1 and 2 [EPIC-1and EPIC-2], were conducted between January 2003 and February 2007 at98 different centers in Canada, Europe, Israel, and the United States.There were 363 and 375 patients involved respectively, all with Crohn’sdisease which was in remission at the time. Patients were randomlyassigned in approximately equal numbers to either a group administeredfour grams per day of omega-3 fatty acids or a placebo, to be taken forup to 58 weeks.
Therewas no significant difference found in the relapse rates between thetwo treatment groups in either of the trials. In EPIC-1, 54 patientstreated with the fatty acids and 62 patients with placebo experienced aclinical relapse. The set of patients experiencing a relapse within 360days in the omega-3 group was estimated to be 31.6%, compared with35.7% in the placebo group. EPIC-2 had 84 patients who were treatedwith omega-3 fatty acids and 94 who took the placebo experiencedrelapse. The set of patients experiencing a relapse within 360 days inthe omega-3 group was estimated to be 47.8%, in contrast with 48.8% inthe placebo group.
Any serious adverse events were uncommon, and those that did occur weremostly related to Crohn’s disease itself.
Theresearchers believe that this conclusion is significant because it hasserious implications on the self treatment of Crohn’s patients. “Ourresults are important because the use of alternative medicines ingeneral, and omega-3 free fatty acid formulations in particular, iswidespread among patients with inflammatory bowel disease. This may bedue, in part, to dissemination of the positive results obtained in [atrial by Belluzzi et al]. Given the negative results observed in theEPIC trials and in [a trial by Lorenz-Meyer et al], we do not endorsethis practice, since patients with Crohn disease who are at risk forrelapse would be better served by taking medications of knownefficacy,” they write.
Omega-3 Free Fatty Acids for the Maintenance of Remission inCrohn Disease: The EPIC Randomized Controlled Trials
BrianG. Feagan; William J. Sandborn; Ulrich Mittmann; Simon Bar-Meir; GeertD’Haens; Marc Bradette; Albert Cohen; Chrystian Dallaire; Terry P.Ponich; John W. D. McDonald; Xavier Hébuterne; Pierre Paré; PavelKlvana; Yaron Niv; Sandro Ardizzone; Olga Alexeeva; Alaa Rostom;Gediminas Kiudelis; Johannes Spleiss; Denise Gilgen; Margaret K.Vandervoort; Cindy J. Wong; Guang Yong Zou; Allan Donner; Paul Rutgeerts
JAMA. 2008;299(14):1690-1697.
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Written by Anna Sophia McKenney
Copyright: Medical News Today
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