Systemic Lupus Erythematosus Clinical Trial
Official title:
Omega 3 Fatty Acids, Inflammatory Status and Biochemical Markers of Patients With Systemic Lupus Erythematosus: a Pilot Study
Omega-3 fatty acids have been considered anti-inflammatory lipids based on data from
epidemiological studies of Greenland Eskimos whose diet is rich in fish, sources of
polyunsaturated fatty acids.
Fatty acids from the omega-3 family [mainly the α-linolenic acid, eicosapentaenoic (EPA) and
docosahexaenoic (DHA)], as well as those of the omega-6 family [represented mainly by
linoleic acid and arachidonic acid (AA)] are essential for the synthesis of eicosanoids,
prostaglandins, leukotrienes, thromboxanes and other oxidative factors, major mediators and
regulators of inflammation.
Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease characterized by
the loss of balance of cellular immunoregulation and increased levels of circulating
inflammatory mediators.Thus, omega-3 supplementation could represent additional therapy for
individuals with SLE.
The aim of this study was to investigate the effects of omega-3 fatty acids on circulating
levels of inflammatory and biochemical markers in women with SLE.
This is a pilot clinical trial of omega-3-polyunsaturated fatty acids carried out in SLE
patients followed at the Rheumatology Unit of Hospital das Clínicas, Universidade Federal de
Minas Gerais, UFMG.
Female patients who met the revised American College of Rheumatology (ACR) classification
criteria for SLE (1982/1997)15, age over 18 years old and below 60 years old, who were
taking stable doses of medications for the SLE treatment in the last three months were
included. Exclusion criteria were the following: pregnancy, disease duration of less than
one year, allergy to fish, fish oil or any omega-3 product, omega-3 use within the previous
six months and diagnosis of diabetes mellitus, liver disease, chronic renal failure, any
type of infection at enrollment and/or throughout the study.
A 12 week pilot clinical trial of omega-3 fatty acid supplementation was conducted.
Participants were seen at baseline (T0) and at week 12 (T1) for clinical, laboratory and
nutritional assessment. Participants were also contacted by telephone in week 6 to check on
compliance and any adverse events. The patients were randomized into one of two groups in a
1:1 ratio. Patients in the study group received, throughout 12 weeks, two tablets per day of
omega-3 fatty acids (540mg of EPA and DHA of 100mg; Hiomega-3 supplement of Naturalis®
company - registered in the National Health Department number 4.1480.0006.001-4). Patients
in the control group did not receive the nutrient nor any kind of placebo. All participants
were instructed not to take omega-3 rich foods during the study period. The researcher
(FMMS) who did clinical assessment and the inflammatory and biochemical data assessment was
blind to randomization and intervention.
Variables measured at each visit included: disease activity index, using the Systemic Lupus
Disease Activity Index (SLEDAI-2k)16; damage index (Systemic Lupus International
Collaboration Clinics/American College of Rheumatology damage index - SLICC/ACR)17; fasting
lipid and glucose profile; standard laboratory tests to assess SLE (red and white blood
count, platelet count, creatinine, urinalysis, urine protein/creatinine ratio, anti-dsDNA,
anticardiolipin, C3 and C4 levels); cytokines (IL-6, IL-10), adipokines (leptin,
adiponectin) C-reactive protein (CRP), nutritional assessment, and in use medications.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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