Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Eicosapentaenoic acid (EPA) is an omega-3 polyunsaturated fatty acid predominantly found in fish oils. Its use in inflammatory bowel disorders (IBD), such as Crohn's disease and ulcerative colitis, is primarily based on its anti-inflammatory properties. EPA can be metabolized into eicosanoids that are generally less inflammatory than those derived from arachidonic acid. This mechanistic rationale has prompted investigation of EPA as a potential adjunctive therapy for IBD.

Scientific evidence for EPA's benefit in IBD is limited and mixed. Some early pilot studies and small-scale trials suggested that omega-3 supplementation, including EPA, might reduce relapse rates in Crohn's disease. However, larger randomized controlled trials, such as the EPIC-1 and EPIC-2 studies published in the New England Journal of Medicine (2008), failed to show a significant benefit of enteric-coated EPA-rich omega-3 fatty acids in maintaining remission in Crohn's disease. Evidence for ulcerative colitis is even less robust, with inconsistent results and few high-quality studies.

Systematic reviews and meta-analyses, including those by Cochrane, have concluded that there is insufficient evidence to recommend EPA or omega-3 fatty acids as effective therapy for IBD. While EPA is sometimes used in practice, this is not strongly supported by clinical trial data. Overall, the evidence supporting EPA's use in IBD is limited (rated 2/5), and current guidelines do not recommend it as a standard treatment.

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