(13-02-13) Effect of omega-3 (n−3) fatty acid supplementation in patients with sickle cell anemia: randomized, double-blind,

Effect of omega-3 (n−3) fatty acid supplementation in patients with sickle cell anemia: randomized, double-blind, placebo-controlled trial 1,2,3

1. Ahmed A Daak,
2. Kebreab Ghebremeskel,
3. Zahir Hassan,
4. Bakhita Attallah,
5. Haj H Azan,
6. Mustafa I Elbashir, and
7. Michael Crawford
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Author Affiliations
1. 1From the Faculty of Life Sciences and Computing, London Metropolitan University, London, United Kingdom (AAD, KG, and MC); the Sickle Cell Referral Clinic, Ibn-Aoaf Paediatric Hospital, Khartoum, Sudan (ZH, BA, and HHA); and the Faculty of Medicine, University of Khartoum, Khartoum, Sudan (MIE).
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Author Notes
?? ↵2 Supported by EU FP6 Marie Curie Transfer of Knowledge Programme (contract no. MTKD-CT-2005-029914; KG), Efamol Limited UK (KG), and the Kitchner Memorial Trust Fund and University of Khartoum (AD).
?? ↵3 Address correspondence to K Ghebremeskel, Lipidomics and Nutrition Research Centre, Faculty of Life Sciences and Computing, London Metropolitan University, 166-220 Holloway Road, London N7 8DB, United Kingdom. E-mail: [email protected].

Abstract
Background: Blood cell aggregation and adherence to vascular endothelium and inflammation play a central role in vaso-occlusive crisis in sickle cell disease. The antiaggregatory, antiadhesive, antiinflammatory, and vasodilatory omega-3 (n−3) fatty acids (DHA and EPA) are significantly reduced in patients with the disease.
Objective: The aim was to investigate the therapeutic potential of omega-3 fatty acids for patients with homozygous sickle cell disease in a randomized, placebo-controlled, double-blind trial.
Design: One hundred forty patients recruited from a single center in Sudan were randomly assigned and received, daily, 1 (age 2?C4 y), 2 (age 5?C10 y), 3 (age 11?C16 y), or 4 (age ??17 y) omega-3 capsules containing 277.8 mg DHA and 39.0 mg EPA or placebo for 1 y. Of these patients, 128 were followed up and the data were obtained. The primary and secondary endpoints??rates of clinical vaso-occlusive crisis and hemolytic events, blood transfusion rate, school attendance, and blood count??were analyzed by intention-to-treat analysis (n = 140).
Results: Omega-3 treatment reduced the median rate of clinical vaso-occlusive events (0 compared with 1.0 per year, P < 0.0001), severe anemia (3.2% compared with 16.4%; P< 0.05), blood transfusion (4.5% compared with 16.4%; P < 0.05), white blood cell count (14.4 ?? 3.3 compared with 15.6 ?? 4.0 ??103/??L; P < 0.05), and the OR of the inability to attend school at least once during the study period because of illness related to the disease to 0.4 (95% CI: 0.2, 0.9; P < 0.05).
Conclusion: The findings of this trial, which need to be verified in a large multicenter study, suggest that omega-3 fatty acids can be an effective, safe, and affordable therapy for sickle cell anemia.
First published November 28, 2012, doi: 10.3945/ajcn.112.036319


Source: Am J Clin Nutr January 2013 vol. 97 no. 1 37-44

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