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Study fails to find a benefit of omega-3 fatty acids in multiple sclerosis

NEW YORK (Reuters Health) – Omega-3 fatty acid supplementation did not have beneficial effects on disease activity in patients with relapsing-remitting multiple sclerosis (MS) in the randomized, double-blind, placebo-controlled OFAMS study reported online April 16 in Archives of Neurology.

Omega-3 fatty acids had no beneficial effects on disease activity when compared with placebo as monotherapy or in combination with interferon beta-1a, the study team reports. As expected, interferon beta-1a led to a reduction in magnetic resonance imaging evidence of disease activity, they say.

Some patients with MS use, or have tried, omega-3 fatty acid supplements to control the disease due to the potential anti-inflammatory and neuroprotective effects of the essential fatty acids. However, hard evidence supporting their value in MS is lacking.

“We think this study proves that omega-3 has no beneficial effect on MS disease activity,” Dr. Oivind Torkildsen from Haukeland University Hospital in Bergen, Norway, told Reuters Health. Based on the findings, he added, “We have stopped advising patients to take omega-3 supplements.”

Dr. Torkildsen’s team studied 92 patients aged 18 to 55 years with MS. For six months, half took 1350 mg eicosapentaenoic acid (EPA) and 850 mg docosahexaenoic acid (DHA) daily, while the other half took matching placebo capsules. After six months, all patients received subcutaneously 44 micrograms interferon beta-1a three times a week for another 18 months. The researchers used magnetic resonance imaging to measure disease activity by the number of new T1-weighted gadolinium-enhancing lesions in the brain.

Serum analyses showed a significant increase in omega-3 fatty acid concentrations in the omega-3 arm compared with the placebo arm (mean difference 7.60; p<0.001).

However, according to the researchers, the cumulative number of gadolinium-enhancing MRI lesions during the first six months were similar in the omega-3 fatty acid arm and placebo arm (mean difference 1; p=0.09). No difference in relapse rate was detected after six months (p=0.54) and 24 months (p=0.72). There was also no difference in fatigue or quality of life scores, and “no safety concerns appeared,” the authors say.

“Magnetic resonance imaging disease activity was reduced as expected by interferon beta-1a,” they add.

Dr. Bianca Weinstock-Guttman, an MS researcher from the University at Buffalo in New York, told Reuters Health that the findings don’t mean that no one with MS should be taking omega-3 supplements.

It’s likely, she said, that the supplements combined with diet changes — such as eating less saturated fat, and lowering total cholesterol — may play a role in slowing the course of the disease along with medications.

“The adding on of (fatty acids) may not make a difference if the rest of the diet doesn’t change,” Dr. Weinstock-Guttman, who wasn’t involved in the new study, told Reuters Health.

“I would focus on a good healthy, balanced diet,” agreed Dr. Sharon Lynch, who studies MS treatment at the University of Kansas Medical Center in Kansas City but also wasn’t tied to the new research. “I think we’re better off trying to eat better than taking a bunch of supplements to make up for the fact that we’re not eating better,” she said.

The supplements used in the study, marketed as Triomar, were provided by Pronova Biocare. Merck added some of the additional funding, and study researchers individually reported financial ties to Merck and other pharmaceutical companies.

SOURCE: http://bit.ly/J5MLHx

Arch Neurol 2012.