Arch Neurol：ω-3脂肪酸无益于缓解多发性硬化症

全世界约有2.5亿人患有多发性硬化症（MS），MS是一种中枢神经系统慢性不治之症。一些MS患者服用或试图通过ω-3脂肪酸补充剂来控制病情，因为必需脂肪酸在多发性硬化症被认为具有抗炎和神经保护作用。发表在Arch Neurol杂志上一项新的试验表明：ω-3脂肪酸补充剂对复发缓和多发性硬化症患者疾病病情没有益处。

挪威卑尔根Hauke​​land大学医院Øivind Torkildsen医学博士等开展的一项双盲、安慰剂对照试验中，研究人员评估了ω-3脂肪酸酸补充剂单一疗法或与干扰素β-1a皮下给药组合疗法减少92例MS患者病情。

46例患者每天给予1350毫克二十碳五烯酸和850毫克二十二碳六烯酸，而其他46例患者接受安慰剂。在6个月的时候，所有患者均给予干扰素β-1，每周三次，持续18个月。

研究结果并未显示ω-3ω-3脂肪酸补充剂对疾病有益，无论是作为单一疗法还是与干扰素β结合使用。

研究人员指出，他们的研究结果并不表明ω-3脂肪酸补充剂是有害的，它并不影响β干扰素的治疗作用。

doi:10.1001/archneurol.2012.283
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ω-3 Fatty Acid Treatment in Multiple Sclerosis (OFAMS Study)

Oivind Torkildsen, MD, PhD; Stig Wergeland, MD;et al.

Objective  To investigate whether -3 fatty acids reduce magnetic resonance imaging (MRI) and clinical disease activity in patients with multiple sclerosis, both as monotherapy and in combination with interferon beta-1a treatment.

Design  Multicenter, randomized, double-blind, placebo-controlled clinical trial conducted from 2004 to 2008.

Setting  Thirteen public neurology departments in Norway.

Participants  Patients aged 18 to 55 years with active relapsing-remitting multiple sclerosis, with a disability score equivalent to 5.0 or less on the Kurtzke Expanded Disability Status Scale. Ninety-two patients were randomized to -3 fatty acids (n = 46) or placebo capsules (n = 46).

Interventions  Administration of 1350 mg of eicosapentaenoic acid and 850 mg of docosahexaenoic acid daily or placebo. After 6 months, all patients in addition received subcutaneously 44 μg of interferon beta-1a 3 times per week for another 18 months.

Main Outcome Measure  The primary outcome measure was MRI disease activity as measured by the number of new T1-weighted gadolinium-enhancing lesions during the first 6 months. Secondary outcome measures included MRI disease activity after 9 months and 24 months, relapse rate, disability progression, fatigue, quality of life, and safety.

Results  The cumulative number of gadolinium-enhancing MRI lesions during the first 6 months were similar in the -3 fatty acids and placebo groups (median difference, 1; 95% CI, 0 to 3; P = .09). No difference in relapse rate was detected after 6 (median difference, 0; 95% CI, 0 to 0; P = .54) or 24 (median difference, 0; 95% CI, 0 to 0; P = .72) months. The proportion of patients without disability progression was 70% in both groups (P > .99). No differences were detected in fatigue or quality-of-life scores, and no safety concerns appeared. Serum analyses of fatty acids showed an increase in -3 fatty acids (mean difference, 7.60; 95% CI, 5.57 to 7.91; P < .001) in the patients treated with -3 fatty acids compared with the placebo group.

Conclusion  No beneficial effects on disease activity were detected from -3 fatty acids when compared with placebo as monotherapy or in combination with interferon beta-1a. Magnetic resonance imaging disease activity was reduced as expected by interferon beta-1a.