Skip to main content
Top
Published in: Clinical Rheumatology 4/2019

01-04-2019 | Vulgar Psoriasis | Review Article

Efficacy of ω-3 supplementation in patients with psoriasis: a meta-analysis of randomized controlled trials

Authors: Cain C. T. Clark, Mohsen Taghizadeh, Mina Nahavandi, Sadegh Jafarnejad

Published in: Clinical Rheumatology | Issue 4/2019

Login to get access

Abstract

Several studies have been conducted with the aim of investigating the effect of Omega(ω)-3 on different psoriasis indices including Psoriasis Area and Severity Index (PASI) score, erythema, scaling, itching, area involved, and infiltration. Nevertheless, a pooled analysis of trials that evaluated these variables has not been conducted. Therefore, the aim of this meta-analysis was to assess the efficacy of ω-3 fatty acids in treating patients with psoriasis. We searched through different electronic, references of retrieved articles, and previous related reviews databases up to November 2018. Both combined and stratified analyzes were conducted. A fixed-effects or random effects model was used to assess the mean effect sizes. An eventual 10 studies involving 560 participants were considered as eligible for inclusion in the present meta-analysis. The meta-analysis indicated a significant reduction in PASI score by − 1.58 (95% confidence interval (CI), − 2.24, − 0.92; P < 0.001) in favor of ω-3 polyunsaturated fatty acid (PUFA) group. The random effects model showed a statistically significant beneficial effect of ω-3 PUFA supplementation on reducing erythema by − 1.66 unit and reducing scaling (weighted mean difference (WMD), − 0.69; 95% CI, − 1.26, − 0.13; P = 0.02). Significant improvements in erythema, itching, and scale were observed in the trials which used the higher dosage of ω-3 supplementation. The results of current meta-analysis study support the use of ω-3 PUFA supplementation for the improvement of the evaluated parameters in psoriatic patients. However, well-controlled and randomized studies are needed to confirm the veracity of non-significant and/or equivocal findings.
Literature
1.
go back to reference Guida B, Napoleone A, Trio R, Nastasi A, Balato N, Laccetti R, Cataldi M (2014) Energy-restricted, n-3 polyunsaturated fatty acids-rich diet improves the clinical response to immuno-modulating drugs in obese patients with plaque-type psoriasis: a randomized control clinical trial. Clin Nutr 33(3):399–405CrossRefPubMed Guida B, Napoleone A, Trio R, Nastasi A, Balato N, Laccetti R, Cataldi M (2014) Energy-restricted, n-3 polyunsaturated fatty acids-rich diet improves the clinical response to immuno-modulating drugs in obese patients with plaque-type psoriasis: a randomized control clinical trial. Clin Nutr 33(3):399–405CrossRefPubMed
2.
go back to reference Rahman M, Beg S, Ahmad MZ, Kazmi I, Ahmed A, Rahman Z, Ahmad FJ, Akhter S (2013) Omega–3 fatty acids as pharmacotherapeutics in psoriasis: current status and scope of nanomedicine in its effective delivery. Curr Drug Targets 14(6):708–722CrossRefPubMed Rahman M, Beg S, Ahmad MZ, Kazmi I, Ahmed A, Rahman Z, Ahmad FJ, Akhter S (2013) Omega–3 fatty acids as pharmacotherapeutics in psoriasis: current status and scope of nanomedicine in its effective delivery. Curr Drug Targets 14(6):708–722CrossRefPubMed
3.
go back to reference Adil M, Singh PK, Maheshwari K (2017) Clinical evaluation of omega-3 fatty acids in psoriasis. Dermatology Review/Przeglad Dermatologiczny 104(3) Adil M, Singh PK, Maheshwari K (2017) Clinical evaluation of omega-3 fatty acids in psoriasis. Dermatology Review/Przeglad Dermatologiczny 104(3)
4.
go back to reference Burns T (2010) Rook’s textbook of dermatology. print and online package. Wiley-Blackwell, Burns T (2010) Rook’s textbook of dermatology. print and online package. Wiley-Blackwell,
5.
go back to reference Upala S, Yong WC, Theparee T, Sanguankeo A (2017) Effect of omega-3 fatty acids on disease severity in patients with psoriasis: a systematic review. Int J Rheum Dis 20(4):442–450CrossRefPubMed Upala S, Yong WC, Theparee T, Sanguankeo A (2017) Effect of omega-3 fatty acids on disease severity in patients with psoriasis: a systematic review. Int J Rheum Dis 20(4):442–450CrossRefPubMed
6.
go back to reference Qin S, Wen J, Bai X-C, Chen T-Y, Zheng R-C, Zhou GB, Ma J, Feng J-Y, Zhong B-L, Li Y-M (2014) Endogenous n-3 polyunsaturated fatty acids protect against imiquimod-induced psoriasis-like inflammation via the IL-17/IL-23 axis. Mol Med Rep 9(6):2097–2104CrossRefPubMedPubMedCentral Qin S, Wen J, Bai X-C, Chen T-Y, Zheng R-C, Zhou GB, Ma J, Feng J-Y, Zhong B-L, Li Y-M (2014) Endogenous n-3 polyunsaturated fatty acids protect against imiquimod-induced psoriasis-like inflammation via the IL-17/IL-23 axis. Mol Med Rep 9(6):2097–2104CrossRefPubMedPubMedCentral
7.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151(4):264–269 w264CrossRef Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151(4):264–269 w264CrossRef
8.
go back to reference Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17(1):1–12CrossRef Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17(1):1–12CrossRef
10.
go back to reference Balbás GM, Regaña MS, Millet PU (2011) Study on the use of omega-3 fatty acids as a therapeutic supplement in treatment of psoriasis. Clin Cosmet Investig Dermatol 4:73CrossRefPubMedPubMedCentral Balbás GM, Regaña MS, Millet PU (2011) Study on the use of omega-3 fatty acids as a therapeutic supplement in treatment of psoriasis. Clin Cosmet Investig Dermatol 4:73CrossRefPubMedPubMedCentral
11.
go back to reference Bittiner S, Cartwright I, Tucker W, Bleehen S (1988) A double-blind, randomised, placebo-controlled trial of fish oil in psoriasis. Lancet 331(8582):378–380CrossRef Bittiner S, Cartwright I, Tucker W, Bleehen S (1988) A double-blind, randomised, placebo-controlled trial of fish oil in psoriasis. Lancet 331(8582):378–380CrossRef
12.
go back to reference Bjørneboe A, Smith AK, Bjørneboe GEA, Thune P, Drevon C (1988) Effect of dietary supplementation with n-3 fatty acids on clinical manifestations of psoriasis. Br J Dermatol 118(1):77–83CrossRefPubMed Bjørneboe A, Smith AK, Bjørneboe GEA, Thune P, Drevon C (1988) Effect of dietary supplementation with n-3 fatty acids on clinical manifestations of psoriasis. Br J Dermatol 118(1):77–83CrossRefPubMed
13.
go back to reference Escobar S, Achenbach R, Iannantuono R, Torem V (1992) Topical fish oil in psoriasis—a controlled and blind study. Clin Exp Dermatol 17(3):159–162CrossRefPubMed Escobar S, Achenbach R, Iannantuono R, Torem V (1992) Topical fish oil in psoriasis—a controlled and blind study. Clin Exp Dermatol 17(3):159–162CrossRefPubMed
14.
go back to reference Grimminger F, Mayser P, Papavassilis C, Thomas M, Schlotzer E, Heuer K-U, Führer D, Hinsch K-D, Walmrath D, Schill W-B (1993) A double-blind, randomized, placebo-controlled trial of n-3 fatty acid based lipid infusion in acute, extended guttate psoriasis. Clin Investig 71(8):634–643CrossRefPubMed Grimminger F, Mayser P, Papavassilis C, Thomas M, Schlotzer E, Heuer K-U, Führer D, Hinsch K-D, Walmrath D, Schill W-B (1993) A double-blind, randomized, placebo-controlled trial of n-3 fatty acid based lipid infusion in acute, extended guttate psoriasis. Clin Investig 71(8):634–643CrossRefPubMed
15.
go back to reference Gupta A, Ellis C, Tellner D, Anderson T, Voorhees JJ (1989) Double-blind, placebo-controlled study to evaluate the efficacy of fish oil and low-dose UVB in the treatment of psoriasis. Br J Dermatol 120(6):801–807CrossRefPubMed Gupta A, Ellis C, Tellner D, Anderson T, Voorhees JJ (1989) Double-blind, placebo-controlled study to evaluate the efficacy of fish oil and low-dose UVB in the treatment of psoriasis. Br J Dermatol 120(6):801–807CrossRefPubMed
16.
go back to reference Soyland E, Funk J, Rajka G, Sandberg M, Thune P, Rustad L, Helland S, Middelfart K, Odu S, Falk ES (1993) Effect of dietary supplementation with very-long-chain n-3 fatty acids in patients with psoriasis. N Engl J Med 328(25):1812–1816CrossRefPubMed Soyland E, Funk J, Rajka G, Sandberg M, Thune P, Rustad L, Helland S, Middelfart K, Odu S, Falk ES (1993) Effect of dietary supplementation with very-long-chain n-3 fatty acids in patients with psoriasis. N Engl J Med 328(25):1812–1816CrossRefPubMed
17.
go back to reference Veale D, Torley H, Richards I, O’DOWD A, Fttzsimons C, Belch J, Sturrock R (1994) A double-blind placebo controlled trial of Efamol Marine on skin and joint symptoms of psoriatic arthritis. Rheumatology 33(10):954–958CrossRef Veale D, Torley H, Richards I, O’DOWD A, Fttzsimons C, Belch J, Sturrock R (1994) A double-blind placebo controlled trial of Efamol Marine on skin and joint symptoms of psoriatic arthritis. Rheumatology 33(10):954–958CrossRef
18.
go back to reference Mori T, Kondo H, Hase T, Tokimitsu I, Murase T (2007) Dietary fish oil upregulates intestinal lipid metabolism and reduces body weight gain in C57BL/6J mice. J Nutr 137(12):2629–2634CrossRefPubMed Mori T, Kondo H, Hase T, Tokimitsu I, Murase T (2007) Dietary fish oil upregulates intestinal lipid metabolism and reduces body weight gain in C57BL/6J mice. J Nutr 137(12):2629–2634CrossRefPubMed
19.
go back to reference Spuls PI, Lecluse LL, Poulsen M-LN, Bos JD, Stern RS, Nijsten T (2010) How good are clinical severity and outcome measures for psoriasis?: quantitative evaluation in a systematic review. J Investig Dermatol 130(4):933–943CrossRefPubMed Spuls PI, Lecluse LL, Poulsen M-LN, Bos JD, Stern RS, Nijsten T (2010) How good are clinical severity and outcome measures for psoriasis?: quantitative evaluation in a systematic review. J Investig Dermatol 130(4):933–943CrossRefPubMed
20.
go back to reference Sterne JA, Egger M (2001) Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol 54(10):1046–1055CrossRefPubMed Sterne JA, Egger M (2001) Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol 54(10):1046–1055CrossRefPubMed
Metadata
Title
Efficacy of ω-3 supplementation in patients with psoriasis: a meta-analysis of randomized controlled trials
Authors
Cain C. T. Clark
Mohsen Taghizadeh
Mina Nahavandi
Sadegh Jafarnejad
Publication date
01-04-2019
Publisher
Springer London
Published in
Clinical Rheumatology / Issue 4/2019
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-019-04456-x

Other articles of this Issue 4/2019

Clinical Rheumatology 4/2019 Go to the issue