Abstract 1317: A randomized placebo-controlled trial of omega-3-polyunsaturated fatty acids on disease activity and endothelial function in systemic lupus erythematosus.
Authors:
SA Wright, FM O’Prey, MT McHenry, WJ Leahey, AB Devine, EM Duffy, DG Johnston, MB Finch, GE McVeigh, AL Bell.
Background:
Omega-3 polyunsaturated fatty acids have been shown to decrease cardiovascular disease in several trials (DART, GISSI). In animals they decrease cytokines, free radicals, adhesion molecules and prolong survival. Several past studies in human SLE have suggested benefit.
Methods:
A 24 week trial of omega-3 (1.8 EPA and 1.2 DHA) va an olive oil placebo was performed. There were 4 dropouts due to nausea. Platelet 8-isoprostanes (oxidative stress) and platelet cell membrane fatty acid were measured. Flow mediated dilatation was the outcome.
Results:
There was increased flow mediated dilatation (p<0.001).
Oxidative damage as measured by platelet 8-isoprostanes was reduced.
Disease activity, measured as SLAM-R, was significantly reduced (p<0.001).
Conclusion:
Omega-3 polyunsaturated fatty acids improved both endothelial function and disease activity in SLE.
Editorial Comment:
From the questions period several issues arose.
It appeared that some of the enrolled subjects had been in previous studies of omega-3.
The authors had tried a previous supplement that wasn’t well tolerated.
The improvement in disease activity included constitutional, headaches, skin and joints – but the constitutional and headache measures on SLAM-R may not be specific for lupus disease activity.
It isn’t clear whether brachial artery FMD really generalizes to the much smaller coronary arteries in SLE.
However, this is a fascinating trial suggesting a novel way of addressing the cardiovascular risk in SLE.
