The effect of combined fish oil and evening primrose oil (Efamol Marine) on the remission phase of psoriasis: A 7-month double-blind randomized placebo-controlled trial

Effects of fish oil supplement on psoriasis: a meta-analysis of randomized controlled trials

“…The fish oil supplement was administered orally in the form of capsule or oil in 11 RCTs [12–14, 16–19, 21–24] and given intravenously as lipid emulsion in 2 RCTs [15, 20]. Three RCTs used capsules containing a combination of fish oil and evening primrose oil [21, 23, 24]. Five of the 13 included RCTs reported benefits of fish oil supplement in treating psoriasis [12, 14, 15, 17, 20]; the other eight RCTs, however, suggested fish oil supplement was not better than control treatment [13, 16, 18, 19, 21–24].…”

“…of tablets/week), Paracetamol (no. of tablets/week), lab tests, AEs.Madland 2006 [19]Polyarticular psoriatic arthritis.10 ml seal oil self administered orally before meals thrice daily for 14 days (2.4 g EPA, 1.1 g DPA, 2.6 g DHA per day).10 ml soy oil self administered orally before meals thrice daily for 14 days.Joint pain intensity, patient’s global assessment, number of tender and swollen joints, PASI, lab tests.Mayser 1998 [20]Inpatients between 18 and 80 years of age with chronic plaque psoriasis; PASI ≥15.Infusions with a ω-3 fatty acid–based lipid emulsion (Omegavenous) 100 ml twice daily for 14 days (4.2 g of both EPA and DHA/day).Infusions with a conventional ω-6-lipid emulsion (Lipovenous) 100 ml twice daily for 14 days.PASI, PASI 50, intensity of psoriasis, self assessment (VAS), AEs, SAEs, lab tests.Oliwiecki 1994 [21]Chronic stable plaque psoriasis; 16–70 years old.Placebo capsules (500 mg liquid paraffin) 6# bid for 4 weeks then receiving active treatment (capsules containing 430 mg evening primrose oil + 107 mg fish oil + 10 mg vitamin E; 6# bid) for the next 24 weeks (1.284 g fish oil per day).Placebo capsules (500 mg liquid paraffin) 6# bid for 28 weeks.10 cm linear analogue scale to measure erythema, scaling and overall severity; plaque thickness; patient self-assessment.Søyland 1993 [22]Stable plaque psoriasis with BSA > 8%.6 capsules daily, each containing 1 g of highly concentrated ethyl esters of very-long-chain n-3 fatty acids (3.06 g EPA + 1.92 g DHA per day), for 4 months.6 capsules of corn oil daily, each containing 1 g, for 4 months.PASI, erythema, infiltration, desquamation, subjective score based on degree of redness, scaling, itching and general effects of the disease on daily living.Strong 1993 [23]Chronic stable plaque psoriasis of an extent sufficient to warrant inpatient admission.Treated with conventional tar and dithranol during admission ➔ Efamol Marine capsules 500 mg 6# twice daily (containing 80% evening primrose oil and 20% fish oil; 216 mg EPA + 240 mg DHA per day) for up to 7 months after discharge.Treated with conventional tar and dithranol during admission ➔ placebo capsules 600 mg 6# twice daily (containing liquid paraffin) for up to 7 months after discharge.Rate of deterioration after discharge (global score, based on BSA, redness, scaling, overall impression, and itch), blood tests.Veale 1994 [24]Chronic stable plaque psoriasis and psoriatic arthritis.12 Efamol Marine capsules daily (total daily dose of 480 mg GLA, 240 mg EPA and 132 mg DHA) for 9 months ➔ placebo capsules for 3 months.12 placebo capsules daily (containing liquid paraffin) for 12 months.Chang/improvement in inflammatory joint disease, grip strength, number of active joint, Ritchie articular index, duration of morning stiffness, NASID intake, skin severity (VAS), BSA, itch (VAS), blood tests. AE Adverse event, ASDAS Ankylosing Spondylitis Disease Activity Score, BASDAI Bath Ankylosing Spondylitis Disease Activity Index, BASMI Bath Ankylosing Spondylitis Metrology Index, BSA Body surface area in...…”

Effect of omega‐3 fatty acids on disease severity in patients with psoriasis: A systematic review

“…LTB4 was found to have significantly decreased in the treatment group (P < 0.03) but not in the control group. The other six studies 5,6,14,15,17,18 reported no significant reduction in scaling, erythema, area involved or thickness. Gupta et al 5 reported the mean time period elapsed before the psoriasis worsened to pre-therapy severity was 4.9 AE 0.5 weeks in the intervention group and 4.5 AE 0.6 weeks in the control group (P = 0.4).…”

“…In spite of that, there was no correlation between clinical response and the increased level of EPA (r = 0.069) or DHA (r = 0.021). Strong et al 18 reported a very substantial improvement in intervention and control groups yet no significant difference between both groups. Details of outcome are presented in Table 2.…”

“…A total of 720 articles were excluded because they were not randomized controlled trials or observational studies (427 articles), did not involve dietary or pharmacologic interventions with n-3 fatty acids (210 articles), did not perform a comparison (65 articles), or did not include the outcome of interest (18 articles). Eleven randomized controlled trials [4][5][6][11][12][13][14][15][16][17][18] and one open-label controlled observational study 19 were included, and the data of all 12 studies were extracted. The characteristics of the extracted studies are outlined in Table 1.…”