Treatment of Rheumatoid Arthritis with Marine and Botanical Oils: An 18‐Month, Randomized, and Double‐Blind Trial

Abstract

Objective. To determine whether a combination of borage seed oil rich in gamma linolenic acid (GLA) and fish oil rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) is superior to either oil alone for treatment of rheumatoid arthritis (RA). Methods. Patients were randomized into a double-blind, 18-month trial. Mixed effects models compared trends over time in disease activity measures. Results. No significant differences were observed in changes in disease activity among the three randomized groups. Each group exhibited significant reductions in disease activity (DAS28) at 9 months (fish: −1.56[−2.16, −0.96], borage: −1.33[−1.83, −0.84], combined: −1.18[−1.83, −0.54]) and in CDAI (fish: −16.95[−19.91, −13.98], borage: −11.20[−14.21, −8.19], and combined: −10.31[−13.61, −7.01]). There were no significant differences in change of RA medications among the three groups. Reduced disease activity in study patients was similar to matched patients from an RA registry, and reduction in DMARD use was greater (P < 0.03) in study patients. Conclusion. All 3 treatment groups exhibited similar meaningful clinical responses after 9 months, improvements which persisted for 18 months, and a response similar to matched patients from an RA registry. Study patients were able to reduce DMARD therapy given in combination with TNF antagonists to a greater extent than registry patients. This paper is dedicated to the memory of Dr. John T. Sharp, M.D., a pioneer and innovator in the field of musculoskeletal radiology

Resolvin D3 Is Dysregulated in Arthritis and Reduces Arthritic Inflammation

“…Omega-3 PUFA, such as EPA and DHA, are now appreciated to exert beneficial actions in several human diseases with underlying inflammatory condition, like RA (26, 27), but their mechanisms have remained a subject of interest. In this regard, recent randomized controlled human trials indicate that omega-3 intake elevated 17-HDHA and RvD1 plasma levels in patients with chronic kidney diseases (28) as well as in chronic knee effusions and plasma in arthritis patients (29).…”

Complementary and alternative medicine for rheumatic diseases: A systematic review of randomized controlled trials

“…Five studies on nonvitamin, nonmineral, natural products were non-inferiority studies-one study showed that SKI306X, which consists of biologically active ingredients from three plants, was not inferior to celecoxib for patients with RA 83 , another study showed that Chuanhu anti-gout mixture, a TCM, was not inferior to colchicine 60 ; a study demonstrated that GCSB-5 is comparable to Celecoxib in terms of the efficacy and safety for treatment of OA of knee joint 84 ; another study demonstrated that treatment with MD-Knee was not inferior of the treatment with SUPARTZ® (sodium hyaluronate), with a confidence level higher than 99% 85 ; another study could not confirm the premise of combination of borage and fish oils would be superior to either oil alone 86 .…”

Medicinal plants used against various inflammatory biomarkers for the management of rheumatoid arthritis

“…[ 105–107 ] Therefore, the borage oil comprises of gamma‐linolenic acid exhibiting anti‐arthritic activity as the clinical study evaluated the gamma‐linolenic acid in the combined supplement for the treatment of arthritis and tends to be beneficial in reducing the inflammatory responses indicating the borage oil as potential therapy for arthritis. [ 108 ] Boswellia serrata Linn . – A traditional medicinal resin gum extracted from Boswellia tree belonging to the Burseraceae family has been used in the treatment of rheumatoid arthritis and exhibits a potent anti‐inflammatory activity due to the presence of active constituents such as terpenoids.…”