Evidence supporting the use of: Eicosapentaenoic Acid
For the health condition: Rheumatoid Arthritis

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Eicosapentaenoic Acid (EPA) is an omega-3 polyunsaturated fatty acid primarily found in fish oil. Its use in supporting or treating rheumatoid arthritis (RA) is backed by scientific evidence, though the effect size is moderate. Numerous randomized controlled trials (RCTs) and meta-analyses have evaluated the efficacy of EPA (often combined with docosahexaenoic acid, DHA) in reducing disease activity and symptoms in RA patients. The proposed mechanism involves EPA’s anti-inflammatory properties: it serves as a precursor to anti-inflammatory eicosanoids and reduces production of pro-inflammatory cytokines and mediators such as leukotriene B4. Clinical studies suggest that supplementation with EPA can lead to a modest reduction in joint pain, morning stiffness, and the need for non-steroidal anti-inflammatory drugs (NSAIDs). A 2012 Cochrane review concluded that fish oil supplementation in RA provides statistically significant, though clinically modest, benefits in joint pain and duration of morning stiffness. The American College of Rheumatology notes omega-3 supplementation as a possible adjunct therapy. However, EPA is not a substitute for disease-modifying antirheumatic drugs (DMARDs) but may be used as a supportive therapy. Most benefits are observed at higher daily doses (e.g., ≥2.7 g EPA/DHA combined). Side effects are generally mild and include gastrointestinal discomfort. In summary, the use of EPA in RA is scientifically validated as an adjunct, with moderate evidence supporting its modest benefits in symptom management.

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