Gan RW, et al. - The purpose of this study is to investigate whether, in anti-CCP+ subjects, omega-3 fatty acids (n-3 FAs) also play a role in the development of inflammatory arthritis (IA). The outcome of this study suggests that n-3 FAs may potentially lower the risk of transition from anti-CCP positivity to IA, an observation that warrants further investigation.

Methods

• From 2008 to 2014, participants without a previous diagnosis of RA who were anti-CCP3+ (n = 47) were selected into a follow-up study at Colorado-based health fairs.
• In this study, symptom assessments and joint examinations were conducted every 6 months for the determination of IA.
• They measured n-3 FAs as a percentage of total lipids in red blood cell membranes (n-3 FA%) at each visit.

Results

• At the baseline visit, they detected IA in 10 anti-CCP3+ subjects (21%).
• Increased total n-3 FA% in red blood cell membranes [odds ratio (OR) = 0.09, 95% CI: 0.01, 0.76], particularly docosapentaenoic acid (OR = 0.16, 95% CI: 0.03, 0.83) and docosahexaenoic acid (OR = 0.23, 95% CI: 0.06, 0.86), was related to a lower odds of IA at the baseline visit, adjusting for n-3 FA supplement use, current smoking, RF+, elevated CRP+ and shared epitope.
• They followed 35 of the anti-CCP3+ subjects who were IA negative at baseline and detected 14 incident IA cases over an average of 2.56 years of follow-up.
• In a time-varying survival analysis, increasing docosapentaenoic acid significantly reduced risk of incident IA (hazard ratio = 0.52, 95% CI: 0.27, 0.98), adjusting for age at baseline, n-3 FA supplement use, RF+, CRP+ and shared epitope.