A Cochrane review [Abstract] 1 included 6 studies on polyunsaturated fatty acids (PUFAs) for multiple sclerosis (MS), with a total of 794 subjects. Patients with both relapsing remitting and chronic progressive MS were included. PUFAs were compared to oleic acid. The interventions were given for 24 to 30 months. PUFAs did not have a significant effect on disease progression (Disability Status Scale). Omega-6 fatty acids (11 to 23 g/day linoleic acid) didn't show any benefit in 144 MS patients (RR 1.04, 95% CI 0.66 to 1.63). Linoleic acid (2.9 to 3.4 g/day) had no benefit in 65 chronic progressive MS patients (RR 0.78, 95% CI 0.43 to 1.42). Omega-3 fatty acids had no benefit in 292 relapsing remitting MS patients (RR 0.82, 95% CI 0.65 to 1.03, p=0.08). Slight potential benefits in relapse outcomes over 2 years were associated with omega-6 fatty acids (WMD 0.79, 95% CI 0.63 to 1.00; 2 studies, n=132), however these findings were limited by the reduced validity of the endpoints. No judgements about safety or patient-reported outcomes were possible. No studies on vitamin supplementation and allergen-free diets were analysed as none met the eligibility criteria, mainly due to lack of clinical outcomes.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and blinding), inconsistency (heterogeneity in patients and interventions) and imprecise results (few patients and wide confidence intervals).
Primary/Secondary Keywords