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Evidence summaries

Omega 3 Fatty Acids (Fish Oil) for Maintenance of Remission in Crohn's Disease

Omega 3 fatty acids might possibly be effective for maintenance of remission in Crohn's disease although the evidence is insufficient. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 6 studies with a total of 1 039 subjects. There was a marginal significant benefit of n-3 therapy for maintaining remission (RR 0.77, 95% CI 0.61 to 0.98). However, the studies were both clinically and statistically heterogeneous (P = 0.03, I2 = 58%). Thirty-seven per cent of patients in the n-3 group relapsed at 12 months compared to 42% of placebo patients (2 studies, 738 patients; RR 0.88, 95% CI 0.74 to 1.05). No significant heterogeneity was identified for this pooled analysis ( I2 = 0%). No serious adverse events were recorded in any of the studies but in pooled analyses there was a significantly higher rate of diarrhea (RR 1.36 95% CI 1.01 to 1.84) and symptoms of the upper gastrointestinal tract (RR 1.65 95% CI 1.25 to 2.18) in the n-3 treatment group.

Comment: The quality of evidence is downgraded by inconsistency (variability in results across studies), by imprecise results (wide confidence intervals), and by potential publication bias.

    References

    • Lev-Tzion R, Griffiths AM, Leder O et al. Omega 3 fatty acids (fish oil) for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev 2014;(2):CD006320. [PubMed]

Primary/Secondary Keywords