Omega-3 polyunsaturated fatty acids in early undifferentiated peripheral arthritis

Abstract

Objective: to study the effect of a drug of omega-3 polyunsaturated fatty acids (omega-3 PUFA) in patients with early undifferentiated peripheral arthritis (UPA) on the development of rheumatoid arthritis (RA), the induction of remission, the use of disease-modifying antirheumatic drugs (DMARDs), the immunological manifestations of the disease during a 12-week follow-up. Subjects and methods. The study enrolled 40 patients with UPA and a symptom duration of less than 12 months, who took nonsteroidal anti-inflamma tory drugs (NSAIDs) and omega-3 PUFA (Vitrum Cardio Omega-3) as one capsule twice daily for 12 weeks. A control group comprised 20 patients with UPA receiving therapy with NSAIDs for 3 months. The groups did not differ significantly (p > 0.05) in age (42.98±10.81 and 48.25±13.92 years), the duration of symptoms (6.73±2.81 and 5.95±2.54 months), the number of patients positive for rheumatoid factor [14 (35%) and 7 (35%)] and antibodies to cyclic citrullinated peptide [9 (22.5%) and 7 (35%)] patients, the duration of morning stiffness (35.6±25.82 and 37.0±19.15 min), the number of swollen (3.08±1.39 and 3.30±1.21) and tender (3.63±1.63 and 3.85±1.69) joints, and DAS 28 (4.21±0.65 and 4.35±0.63). Results. The use of omega-3 PUFA did not affect significantly the incidence of RA and the use of DMARDs. Clinical remission and low DAS28 were considerably observed in the study group patients, but no statistical significance was achieved. The dose of NSAIDs, including on-demand drugs, was decreased in 22 (55%) and 4 (20%) patients in the study and control groups, respectively (p = 0.013). At 12 weeks, the study group showed signifi cant reductions in the number of tender joints, the duration of morning stiffness, erythrocyte sedimentation rate, DAS 28, and interleukin 6 levels (p < 0.05); no significant changes were found in the control group. There were no significant differences in the frequency of undesirable events. Conclusion. Omega-3 PUFAs contribute to the control of the activity of an inflammatory process, show some immunomodulatory properties, and can optimize the use of NSAIDs in patients with early UPA.