Double-blind, multicentre analysis of the efficacy of borage oil in patients with atopic eczema

Although gamma-linolenic acid (GLA) has been shown to correct deficiencies in skin lipids associated with reduced delta-6-desaturase activity which sh ould result in improvement of dysregulation of inflammation and immunity in atopic eczema, clinical studies with evening primrose oil containing 10% G LA have yielded contradictory results. We have therefore examined the effec t of a higher percentage (at least 23%) GLA-containing borage oil in adults with stable atopic eczema of moderate severity in a double-blind multicent re study. One hundred and sixty patients were randomized to take daily eith er 500 mg of borage oil-containing capsules or the bland lipid miglyol as a placebo over a 24-week period. Use of topical diflucortolone-21-valerate c ream was allowed as, rescue medication, with the amount used until response being defined as primary, and clinical improvement as secondary efficacy c riteria. Although several clinical symptoms improved compared with placebo, the overall response to borage oil did not reach statistical significance. Significant differences in favour of borage oil were, however, observed in a subgroup excluding patients,who failed to show increased erythrocyte dih omo-gamma-linolenic acid levels and in whom adherence to inclusion criteria and the study protocol were questionable. GLA metabolites increased in bor age oil-treated patients only and serum IgE showed a trend to decrease on o verall and subgroup analysis. No substance-related adverse effects were obs erved. This study shows no overall efficacy of GLA-containing borage oil in atopic eczema, with steroid use being the primary response parameter, alth ough it suggests that a subgroup of patients may benefit from this well-tol erated treatment.