Effectiveness of N-3 fatty acids supplementation on spondyloarthritis: A systematic review and meta-analysis

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2024-10-23 DOI:10.1016/j.clnu.2024.10.024

Elpida Skouvaklidou , Xenophon Theodoridis , Eleni Tziona , Periklis Vounotrypidis , Theodoros Dimitroulas , Michail Chourdakis

{"title":"Effectiveness of N-3 fatty acids supplementation on spondyloarthritis: A systematic review and meta-analysis","authors":"Elpida Skouvaklidou , Xenophon Theodoridis , Eleni Tziona , Periklis Vounotrypidis , Theodoros Dimitroulas , Michail Chourdakis","doi":"10.1016/j.clnu.2024.10.024","DOIUrl":null,"url":null,"abstract":"<div><h3>Background & aims</h3><div>The study aims to systematically review and meta-analyze randomized controlled trials (RCTs) assessing the effects of n-3 fatty acids (FA) supplementation on spondyloarthritis (SpA) disease activity, inflammatory markers, and imaging.</div></div><div><h3>Methods</h3><div>The study protocol was developed and registered online in advance. The PubMed, SCOPUS, and Cochrane Central Register of Controlled Trials (CENTRAL) electronic databases were systematically searched for RCTs up to April 2024. Two independent reviewers screened, assessed for eligibility, and extracted data from the eligible RCTs. The revised Cochrane Risk of Bias tool was used to assess the quality of trials. The random-effects model was used to calculate the pooled estimates.</div></div><div><h3>Results</h3><div>We included four RCTs, involving 245 patients with SpA. Supplementation with n-3 FA did not improve physician-reported outcomes [number of tender joints (four trials, standardized mean difference (SMD): −0.22; 95 % confidence interval (CI): −0.74 to 0.29; I<sup>2</sup> = 61 %), number of swollen joints (two trials, SMD: −0.13; 95 % CI: −0.42 to 0.15; I<sup>2</sup> = 0 %)], and patient-reported outcomes [pain (three trials, SMD: −0.16; 95 % CI: −1.03 to 0.70; I<sup>2</sup> = 74 %), Health Assessment Questionnaire (three trials, SMD: −0.04; 95 % CI: −0.78 to 0.70; I<sup>2</sup> = 71 %). The other nine pre-specified outcomes were not analyzed due to lack of information from the original RCTs which were evaluated as «<em>some concerns</em>» or «<em>high risk</em>» of bias.</div></div><div><h3>Conclusions</h3><div>In the present systematic review and meta-analysis including placebo-controlled RCTs, n-3 FA supplementation did not show improvement in the reported outcomes. Future RCTs should be conducted with homogenous intervention, placebo, and outcomes to re-examine possible beneficial effects.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 233-240"},"PeriodicalIF":6.6000,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nutrition","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0261561424003820","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background & aims

The study aims to systematically review and meta-analyze randomized controlled trials (RCTs) assessing the effects of n-3 fatty acids (FA) supplementation on spondyloarthritis (SpA) disease activity, inflammatory markers, and imaging.

Methods

The study protocol was developed and registered online in advance. The PubMed, SCOPUS, and Cochrane Central Register of Controlled Trials (CENTRAL) electronic databases were systematically searched for RCTs up to April 2024. Two independent reviewers screened, assessed for eligibility, and extracted data from the eligible RCTs. The revised Cochrane Risk of Bias tool was used to assess the quality of trials. The random-effects model was used to calculate the pooled estimates.

Results

We included four RCTs, involving 245 patients with SpA. Supplementation with n-3 FA did not improve physician-reported outcomes [number of tender joints (four trials, standardized mean difference (SMD): −0.22; 95 % confidence interval (CI): −0.74 to 0.29; I² = 61 %), number of swollen joints (two trials, SMD: −0.13; 95 % CI: −0.42 to 0.15; I² = 0 %)], and patient-reported outcomes [pain (three trials, SMD: −0.16; 95 % CI: −1.03 to 0.70; I² = 74 %), Health Assessment Questionnaire (three trials, SMD: −0.04; 95 % CI: −0.78 to 0.70; I² = 71 %). The other nine pre-specified outcomes were not analyzed due to lack of information from the original RCTs which were evaluated as «some concerns» or «high risk» of bias.

Conclusions

In the present systematic review and meta-analysis including placebo-controlled RCTs, n-3 FA supplementation did not show improvement in the reported outcomes. Future RCTs should be conducted with homogenous intervention, placebo, and outcomes to re-examine possible beneficial effects.

查看原文本刊更多论文

补充 N-3 脂肪酸对脊柱关节炎的疗效：系统回顾和荟萃分析

背景& 目的本研究旨在系统回顾和荟萃分析评估补充 n-3 脂肪酸（FA）对脊柱关节炎（SpA）疾病活动、炎症标志物和影像学影响的随机对照试验（RCT）。在PubMed、SCOPUS和Cochrane对照试验中央注册中心（CENTRAL）电子数据库中系统检索了截至2024年4月的RCTs。两名独立审稿人对符合条件的 RCT 进行筛选、资格评估和数据提取。修订版 Cochrane 偏倚风险工具用于评估试验质量。结果我们纳入了四项RCT，涉及245名SpA患者。补充 n-3 FA 并未改善医生报告的结果[触痛关节的数量（四项试验，标准化平均差 (SMD)：-0.22；95 % 置信度）]：-0.22；95% 置信区间 (CI)：-疼痛（三项试验，SMD：-0.16；95 % CI：-1.03 至 0.70；I2 = 74 %），健康评估问卷（三项试验，SMD：-0.04；95 % CI：-0.78 至 0.70；I2 = 71 %）。结论在本系统综述和荟萃分析（包括安慰剂对照的 RCTs）中，补充 n-3 FA 并未改善所报告的结果。今后应采用同质干预、同质安慰剂和同质结果进行 RCT 研究，以重新审查可能的有益效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.