Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Ethyl esters of omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are used as pharmaceutical formulations (such as prescription omega-3 ethyl esters) and dietary supplements. Their use in supporting or treating rheumatoid arthritis (RA) is supported by scientific evidence. Multiple randomized controlled trials and meta-analyses have shown that omega-3 fatty acid supplementation can reduce symptoms of RA, including joint pain and morning stiffness, and may reduce the need for nonsteroidal anti-inflammatory drugs (NSAIDs). The mechanism is thought to involve the anti-inflammatory effects of omega-3 fatty acids, which can decrease the production of inflammatory eicosanoids and cytokines. Notably, a 2017 Cochrane review and other systematic reviews have concluded that omega-3 supplementation offers modest but significant clinical benefits in RA patients. Prescription forms of omega-3 ethyl esters (such as Lovaza and Omacor) are used primarily for hypertriglyceridemia, but their clinical effects on inflammation are well-documented and relevant to RA. However, while the benefits are consistent, they are generally considered adjunctive to standard RA therapies, not replacements. The evidence supporting their use is rated as moderate to strong, hence a 4 on the scale.

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