Comparison of the Effect of Omega-3 Fatty Acid Supplementation with and without Vitamin E in Patients with Rheumatoid Arthritis

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.