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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\n      \u003Ch2\u003ESummary\u003C\/h2\u003E\n      \u003Cp id=\u0022p-1\u0022\u003EA meta-analysis of 17 randomized, controlled trials suggests that supplementation with oral n-3 fatty acids improves patient-assessed pain, duration of morning stiffness, and number of painful and\/or tender joints in patients with rheumatoid arthritis [Bahadori B et al. \u003Cem\u003EJPEN J Parenter Enteral Nutr\u003C\/em\u003E 2010; Kremer JM. \u003Cem\u003EAm J Clin Nutr\u003C\/em\u003E 2007; Goldberg RJ, Katz J. \u003Cem\u003EPain\u003C\/em\u003E 2007].\u003C\/p\u003E\n   \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Erheumatoid arthritis\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n      \u003Cp id=\u0022p-2\u0022\u003EA meta-analysis of 17 randomized, controlled trials suggests that supplementation with oral n-3 fatty acids improves patient-assessed pain, duration of morning stiffness, and number of painful and\/or tender joints in patients with rheumatoid arthritis (RA) [Bahadori B et al. \u003Cem\u003EJPEN J Parenter Enteral Nutr\u003C\/em\u003E 2010; Kremer JM. \u003Cem\u003EAm J Clin Nutr\u003C\/em\u003E 2007; Goldberg RJ, Katz J. \u003Cem\u003EPain\u003C\/em\u003E 2007]. Joel M. Kremer, MD, Albany Medical College and the Center for Rheumatology, Albany, New York, USA, reviewed studies on the efficacy of fish oil in the treatment of RA and its cardiovascular (CV) benefits.\u003C\/p\u003E\n      \u003Cp id=\u0022p-3\u0022\u003EA 24-week, prospective, double-blind, randomized trial of high and low doses of fish oil and olive oil showed significant improvements from baseline in the number of tender joints (p=0.05 for the high dose; p=0.04 with the low dose) and morning stiffness (p\u22640.01) and significant decreases in leukotriene B4 and macrophage IL-1 production, especially in the high-dose n-3 fatty acid group [Kremer JM et al. \u003Cem\u003EArthritis Rheum\u003C\/em\u003E 1990].\u003C\/p\u003E\n      \u003Cp id=\u0022p-4\u0022\u003EA 12-month, double-blind, randomized study [Geusens P et al. \u003Cem\u003EArthritis Rheum\u003C\/em\u003E 1994] compared supplementation with either 2.6 mg of n-3 fatty acids or 1.3 gm of n-3 fatty acids+3 gm of olive oil. Findings indicated that 2.6 gm\/day of n-3 fatty acids led to significant clinical benefit and may have reduced the need for concomitant antirheumatic medication.\u003C\/p\u003E\n      \u003Cp id=\u0022p-5\u0022\u003EAccording to Dr. Kremer, more than 20 peer-reviewed, blinded studies have demonstrated a consistent amelioration of tender joints in patients who have been given n-3 fatty acids versus controls of corn or olive oil. All but two studies added n-3 fatty acids to existing RA treatment regimens.\u003C\/p\u003E\n      \u003Cp id=\u0022p-6\u0022\u003EThe minimal effective dose of n-3 fatty acids per day appears to be 3 to 5 g, or at least 10 capsules per day of most over-the-counter fish oil supplements. These contain about 300 mg of n-3, but \u201chigh-potency\u201d capsules with 500 to 950 mg of n-3 are now available.\u003C\/p\u003E\n      \u003Cp id=\u0022p-7\u0022\u003EThe finding that fish oil decreases CV risk is well established [Mozaffarian D. \u003Cem\u003EAm J Clin Nutr\u003C\/em\u003E 2008; Albert CM et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2002]. A protective effect seems evident at doses of long-chain n-3 fats \u0026gt;250 mg, much lower than those needed for symptomatic relief in RA [James M. \u003Cem\u003EProc Nutr Soc\u003C\/em\u003E 2010].\u003C\/p\u003E\n      \u003Cp id=\u0022p-8\u0022\u003EFish oil may reduce CV events in RA via direct myocardial and, possibly, antithrombotic actions [Cleland LG et al. \u003Cem\u003EJ Rheumatol\u003C\/em\u003E 2006] and may also induce a favorable vascular response to ischemia [DiGiacomo RA et al. \u003Cem\u003EAm J Med\u003C\/em\u003E 1989].\u003C\/p\u003E\n      \u003Cp id=\u0022p-9\u0022\u003EIn a double-blind prospective study, 32 patients with primary or secondary Raynaud phenomenon were randomly assigned to olive oil placebo or fish oil groups. Data indicated that the ingestion of fish oil improved tolerance to cold exposure and delayed the onset of vasospasm in patients with primary (p=0.05), but not secondary, Raynaud phenomenon. The improvements were associated with significantly increased digital systolic blood pressures in cold temperatures [DiGiacomo RA et al. \u003Cem\u003EAm J Med\u003C\/em\u003E 1989].\u003C\/p\u003E\n      \u003Cp id=\u0022p-10\u0022\u003EDr. Kremer recommended three high-potency fish oil capsules (approximately 3 g n-3\/day) in young patients with primary Raynaud, with at least 6 weeks of observation. He noted that the potential of n-3 fatty acids in the amelioration of CV comorbidity in inflammatory diseases, like RA, is worthy of further study.\u003C\/p\u003E\n   \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2011 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/11\/13\/28.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmwop\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}