EFFECT OF AN ENTERIC-COATED FISH-OIL PREPARATION ON RELAPSES IN CROHNS-DISEASE

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.