| Disease | IN RHEUMATOID ARTHRITIS(RA) BENEFIT FROM NON-STEROIDAL ANTI-INFLAMMATORY DRUGS(NSAIDS) IS MEDIATED THROUGH INHIBITION OF THE CYCLO-OXYGENASE ENZYME, THEREBY DECREASING PRODUCTION OF THE 2 SERIES PROSTAGLANDINS(PGS). THE LIPOXYGENASE ENZYME IS
INTACT. HOWEVER, ALLOWING LEUCOTRIENE(LT) PRODUCTION, E.G., LTB4 (AN INFLAMMATORY MEDIATOR). TREATMENT WITH EVENING PRIMROSE OIL(EPO) WHICH CONTAINS GAMMA-LINOLENIC ACID(GLA) LEADS TO PRODUCTION OF THE 1 SERIES PGS, E.G., PGE1, WHICH HAS LESS
INFLAMMATORY EFFECTS. ALSO LT PRODUCTION IS INHIBITED. EICOSAPENTAENOIC ACID(EPA,FISH OIL) TREATMENT PROVIDES A SUBSTRATE FOR PGS AND LTS, WHICH ARE ALSO LESS INFLAMMATORY. IN THIS STUDY 16 PATIENTS WITH RA WERE GIVEN 540 MG GLA/DAY(EPO), 15
PATIENTS 240 MG EPA AND 450 MG GLA/DAY(EPO/FISH OIL), AND 18 PATIENTS AN INERT OIL(PLACEBO). THE AIM OF THIS STUDY WAS TO DETERMINE IF EPO OR EPO/FISH OIL COULD REPLACE NSAID TREATMENT IN RA. THE INITIAL 12 MONTHS SHOWED A SIGNIFICANT SUBJECTIVE
IMPROVEMENT FOR EPO AND EPO/FISH OIL HAD SIGNIFICANTLY REDUCED THEIR NSAIDS. AFTER 3 MONTHS OF PLACEBO THOSE RECEIVING ACTIVE TREATMENT HAD RELAPSED. DESPITE THE DECREASE IN NSAIDS, MEASURES OF DISEASE ACTIVITY DID NOT WORSEN. IT IS SUGGESTED
EPO AND EPO/FISH OIL PRODUCED A SUBJECTIVE IMPROVEMENT AND ALLOW SOME PATIENTS TO REDUCE OR STOP TREATMENT WITH NSAIDS. THERE IS, HOWEVER, NO EVIDENCE THAT THEY ACT AS DISEASE MODIFYING AGENTS. |