Proudman SM et al. - There is high level evidence for symptomatic benefits from fish oil use in rheumatoid arthritis, and there is biologic plausibility for its clinical effects. Fish oil also has safety advantages in reducing cv risk.
Fish oil is not widely used in RA therapy, despite the following benefits:
There is high level evidence for symptomatic benefits
Biologic plausibility for its clinical effects (inhibition of inflammatory mediator production, production of anti-inflammatory mediators)
Reduction in use of NSAIDs, which confer cv risk and gastrointestinal adverse events
Cardioprotective effect in a patient population that has an inherent increased cv risk that is probably augmented by NSAID use
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