A. Belluzzi et al., EFFECT OF AN ENTERIC-COATED FISH-OIL PREPARATION ON RELAPSES IN CROHNS-DISEASE, The New England journal of medicine, 334(24), 1996, pp. 1557-1560
Background. Patients with Crohn's disease may have periods of remissio
n, interrupted by relapses, Because fish oil has antiinflammatory acti
ons, it could reduce the frequency of relapses, but it is often poorly
tolerated because of its unpleasant taste and gastrointestinal side e
ffects. Methods, We performed a one-year, double-blind, placebo-contro
lled study to investigate the effects of a new fish-oil preparation in
the maintenance of remission in 78 patients with Crohn's disease who
had a high risk of relapse, The patients received either nine fish-oil
capsules containing a total of 2.7 g of n-3 fatty acids or nine place
bo capsules daily, A special coating protected the capsules against ga
stric acidity for at least 30 minutes. Results. Among the 39 patients
in the fish-oil group, 11 (28 percent) had relapses, 4 dropped out bec
ause of diarrhea, and 1 withdrew for other reasons, In contrast, among
the 39 patients in the placebo group, 27 (69 percent) had relapses, 1
dropped out because of diarrhea, and 1 withdrew for other reasons (di
fference in relapse rate, 41 percentage points; 95 percent confidence
interval, 21 to 61; P<0.001), After one year, 23 patients (59 percent)
in the fish-oil group remained in remission, as compared with 10 (26
percent) in the placebo group (P=0.003). Logistic-regression analysis
indicated that only fish oil and not sex, age, previous surgery, durat
ion of disease, or smoking status affected the likelihood of relapse (
odds ratio for the placebo group as compared with the fish-oil group,
4.2; 95 percent confidence interval, 1.6 to 10.7). Conclusions. In pat
ients with Crohn's disease in remission, a novel enteric-coated fish-o
il preparation is effective in reducing the rate of relapse. (C) 1996,
Massachusetts Medical Society.