BOSTON, Massachusetts—Omega-3 fish oil may reduce lupus disease activity and improve endothelial function, according to data from a randomized, controlled trial presented at the annual meeting of the American College of Rheumatology in Boston.¹

"This study confirms the beneficial effects of omega-3 fish oils in improving the symptoms of systemic lupus erythematosus (SLE) and also provides evidence for a potential cardioprotective effect in this group of patients," said chief researcher Stephen Wright, MD, specialist registrar in rheumatology, department of therapeutics and musculoskeletal education and research unit at Queen's University of Belfast, Northern Ireland.

The 6-month study of 60 SLE patients with mild disease and no major organ involvement showed that patients who received 3 grams of omega-3 fish oil daily improved in fatigue, headache, arthralgia, myalgia, and skin involvement on the revised Systemic Lupus Activity Measure (SLAM-R) and British Isles Lupus Assessment Group index of disease activity for SLE (BILAG), when compared with their counterparts who received olive oil (placebo).

Patients who took fish oil also showed improvement in flow mediated dilation of the brachial artery, from 3% to 8.9% (P <.001) and in platelet 8-isoprostanes, from 177 pg/mg protein to 90 pg/mg protein (P = .007), the study showed. Patients taking placebo olive oil supplements showed improvement in blood pressure which fits with evidence regarding the cardiovascular benefits of the Mediterranean diet.

There were no changes in laboratory measures such as erythrocyte sedimentation rate (ESR). Dr. Wright said that he did not think the fish oil supplements will have an effect on organ involvement in SLE. "Low dose fish oil supplementation may have disease activity benefit, but patients need to continue taking their conventional medicine," he said.

Let them take fish oil

This is a "great idea," said Timothy McAlindon, MD, MPH, an associate professor of medicine in the division of rheumatology at Tufts New England Medical Center. "There are compelling reasons to consider telling lupus patients to take fish oil supplements. It's a double benefit with little risk."

While patients with other autoimmune disease might benefit from fish oil supplementation, this approach has special appeal for SLE patients because they may not do as well on traditional lipid-lowering drugs as non-SLE patients, according to Dr. McAlindon.

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