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Evidence-Based Complementary and Alternative Medicine
Volume 2014, Article ID 857456, 9 pages
http://dx.doi.org/10.1155/2014/857456
Research Article

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

1University of Massachusetts Medical School, Department of Medicine, Division of Preventive and Behavioral Medicine, 55 Lake Avenue North, Shaw Building, Worcester, MA 01655, USA
2University of Massachusetts Medical School, Department of Medicine, Rheumatology Division, 55 Lake Avenue North, LRB 240, Worcester, MA 01655, USA
3University of Massachusetts Medical School, Department of Family Medicine and Community Health, 55 Lake Avenue North, Benedict Building A3-214, Worcester, MA 01655, USA
4University of Washington School of Medicine, Bainbridge Island, Seattle, WA, USA
5University of Massachusetts Medical School, Department of Medicine, Rheumatology Division, 55 Lake Avenue North, LRB 840D, Worcester, MA 01655, USA

Received 8 November 2013; Accepted 10 February 2014; Published 19 March 2014

Academic Editor: José Luis Ríos

Copyright © 2014 George W. Reed et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 () 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.