Intervention With n-3 Polyunsaturated Fatty Acids in Patients With Rheumatoid Arthritis

This study has been completed.
German Federal Ministry of Education and Research
Information provided by (Responsible Party):
Gerhard Jahreis, University of Jena Identifier:
First received: December 3, 2012
Last updated: December 10, 2013
Last verified: December 2012

The study was performed to investigate the effects of a daily consumption of n-3 LC-PUFA supplemented products (sausage, tomato spread, milk beverage) on disease activity, inflammatory markers, and cardiovascular risk factors in patients with rheumatoid arthritis.

Condition Intervention
Inflamatory Markers and Disease Activity
Dietary Supplement: n-3 LC-PUFA
Dietary Supplement: placebo (sunflower oil)

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double Blind (Subject, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Intervention With Products Enriched With Long Chain n-3 Polyunsaturated Fatty Acids (n-3 LC-PUFA)in Patients With Rheumatoid Arthritis - Influence on Disease Activity and Inflammation Status

Resource links provided by NLM:

Further study details as provided by University of Jena:

Primary Outcome Measures:
  • arachidonic acid/docosahexaenoic acid ratio in plasmal lipids and erythrocyte membranes [ Time Frame: 10 weeks ] [ Designated as safety issue: No ]
    arachidonic acid is a precursor of eicosanoids (leukotriens 4 series, prostaglandins 2 series) docosahexaenoic acid is a precursor of (resolvins and protectins (pro-resolving)

Secondary Outcome Measures:
  • inflammation markers such as erythrocyte sedimation rate (ESR), C reactive protein (CRP), adhesion molecules, disease activity score DAS 28 and DAS68, US-7 score, rheumascan [ Time Frame: 10 weeks ] [ Designated as safety issue: No ]
    disease acitvity parameters

Other Outcome Measures:
  • blood lipids (total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triacylglycerol (TAG), ox LDL, lipoprotein a) [ Time Frame: 10 weeks ] [ Designated as safety issue: No ]
    cardiovascular risk factors

Enrollment: 35
Study Start Date: September 2012
Study Completion Date: May 2013
Primary Completion Date: December 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: n-3 LC-PUFA
algal oil (rich in docosahexaenoic acid) 8 g/day (included in 60g sausage, 8g tomato spread, 30g milk powder)
Dietary Supplement: n-3 LC-PUFA
verum (algal oil)
Placebo Comparator: sunflower oil
sunflower oil 8 g/day (included in 60g sausage, 8g tomato spread, 30g milk powder)
Dietary Supplement: placebo (sunflower oil)

Detailed Description:

Recent studies suggest that the daily intake of n-3 LC-PUFA (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) can support the therapy of chronic-inflammatory diseases and might be useful to prevent coronary heart diseases. The majority of these studies do not differentiate between the effects of EPA and DHA. The present study investigate the effects of DHA in patients with rheumatoid arthritis.

As a precondition for participating in this study, the patients were provided information in writing and verbally about the details of the study. Written informed consent was obtained from all volunteers. Before the beginning of the study, all patients were subject to a medical examination by their general rheumatologist. Thirty five patients with rheumatoid arthritis (DAS ≥ 2.6, erythrocyte sedimation rate (ESR (1h) ≥ 12 mm) should entered the study.

The placebo-controlled, randomized double-blind cross-over study consists of two investigation periods of 10 weeks, with a ten-week washout period in between. After the washout period the intervention was crossed between the groups and the respective products were consumed for another 10 weeks. Patients in the placebo period receive 60g sausage, 8g tomato spread and one bottle of the milk beverage daily. These products were enriched with sunflower oil (8g/d).

In the intervention period, the products (60g sausage, 8g tomato spread and one bottle of the milk beverage) were enriched with 8g alga oil (IOI) The daily dose of docosahexaenoic acid (DHA) amounted to 2.8 g.

Venous blood is collected at the beginning and at the end of each period.

• Disease activity was determined by joint score DAS68, rheumascan, common inflammatory markers (ESR, C reactive protein), ultrasonic (US-7 score), HAQ questionnaire and further lifestyle forms


Ages Eligible for Study:   40 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patient has a diagnosis of RA according to the revised 1987 ACR classification criteria for at least 6 months prior to randomization.
  • Patient has a moderate disease activity as defined by disease activity score DAS28 ≥ 2.6, ESR ≥ 12 mm/hour.
  • Patient has the ability to comprehend the full nature and purpose of the study, including possible risks and side effects, to cooperate with the investigator, to understand verbal and written instructions, and to comply with the requirements of the entire study.
  • stable dosis of disease-modifying antirheumatic drugs within 4 weeks prior to randomization and presumably over the study periods (30 weeks).

Exclusion Criteria:

  • Intra-articular corticosteroids within 4 weeks prior to randomization or blood sample taking
  • Patients are permitted to receive either oral or parenteral glucocorticoids equivalent to ≤10 mg daily prednisone and nonsteroidal anti-inflammatory drug, if they have received a stable dose for at least 4 weeks prior to randomization and presumably over the study periods (30 weeks).
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Please refer to this study by its identifier: NCT01742468

Friedrich Schiller University, Clinic for Internal Medicine
Jena, Germany, 07743
Friedrich Schiller University, Institute of Nutrition
Jena, Germany, 07743
Sponsors and Collaborators
University of Jena
German Federal Ministry of Education and Research
  More Information

No publications provided

Responsible Party: Gerhard Jahreis, Professor, University of Jena Identifier: NCT01742468     History of Changes
Other Study ID Numbers: H53-12
Study First Received: December 3, 2012
Last Updated: December 10, 2013
Health Authority: Ethics committee of the medical faculty of the Friedrich Schiller University Jena: Germany

Keywords provided by University of Jena:
n-3 LC-PUFA, DHA, rheumatoid arthritis

Additional relevant MeSH terms:
Arthritis, Rheumatoid
Autoimmune Diseases
Connective Tissue Diseases
Immune System Diseases
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases processed this record on July 01, 2015