Fish oil tackles arthritis and heart disease

Rheumatoid arthritis (RA) is a chronic disease that causes inflammation of the joints and surrounding tissues. Symptoms of rheumatoid arthritis include pain, stiffness, swelling and deformities. Approximately 2 million people in the United States are believed to have rheumatoid arthritis. In addition, rheumatoid arthritis is associated with a doubled risk of death from cardiovascular disease and a doubled risk of sudden death. NSAIDs, or nonsteroidal anti-inflammatory drugs, are a class of medication that are often used to help with the symptoms of rheumatoid arthritis by reducing tissue inflammation, pain, and swelling. Aspirin, ibuprofen (Advil, Medipren, Motrin), naproxen, and etodolac (Lodine) are examples of NSAIDs that are used to treat this condition.

Although considered effective in treating symptoms NSAIDs are associated with serious upper gastrointestinal complications resulting in over 16,000 deaths and over 100,000 hospitalizations each year in the United States in treating arthritis alone. In addition, NSAIDs are now considered to be involved in increasing the risk of serious risk of cardiovascular (CV) problems. For example, Vioxx has been shown to be involved in tens of thousands of deaths from heart attacks and sudden cardiac death before being removed from the market. Fish oil has been well established as a treatment to reduce the pain associated with rheumatoid arthritis. Unlike NSAIDs, fish oil has not been associated with any gastrointestinal problems and has also been shown to reduce cardiovascular risk. A study in the Journal of Rheumatology, examined long-term use of fish oil in the treatment of rheumatoid arthritis and its effect on cardiovascular risk. The study group compared 18 patients taking fish oil over a 3-year period compared with a group of 13 patients who did not take fish oil. The group taking the fish oil was found to have a much greater remission rate of the disease than the no fish oil group. "The proportion in remission at 3 years was greater in the fish oil-compliant group (72% vs. 31%)." Those in the fish oil group were more likely to be able to stop using NSAIDs than the group not taking fish oil. "Discontinuation of NSAID in 75% of those taking NSAID at baseline in the fish oil group was significant, whereas the discontinuation by 37% of NSAID users in the no fish oil group was not significant." Cardiovascular measurements showed a benefit in the fish oil group. Triglycerides decreased, total cholesterol decreased, and beneficial HDL cholesterol increased. The group that didn't take the fish oil showed no positive changes in these cardiovascular measurements. The authors conclude, "Favourable changes were seen in multiple lipid risk factors for CV disease, and recourse to symptomatic use of NSAID was reduced. Measures of disease activity were generally lower in the compliant fish oil users. Anti-inflammatory doses of fish oil should be considered in patients with RA as a means of reducing CV risk."(Source: The Journal of Rheumatology : January 2007.)