Document Detail


Fish oil supplementation increases the cyclooxygenase inhibitory activity of paracetamol in rheumatoid arthritis patients.
MedLine Citation:
PMID:  20688263     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine interactions between fish oil and paracetamol for inhibition of prostaglandin synthesis in patients with rheumatoid arthritis (RA).
METHODS: Patients from an early RA clinic who were treated with a standardized combination DMARD regimen were enrolled. They were advised to consume an anti-inflammatory dose of fish oil containing the n-3 fatty acid, eicosapentaenoic acid (EPA), or a comparator oil. High EPA and Low EPA groups were defined by blood EPA levels >3.5% or <2%, respectively, of plasma phospholipid fatty acids. Participants provided a blood sample before, and 1h after ingestion of 1g paracetamol. The blood was incubated in different ways to allow measurement of COX-2 generated prostaglandin E(2) (PGE(2)) and COX-1 generated thromboxane A(2) (TXA(2)).
RESULTS: Paracetamol suppressed the eicosanoid measures of COX-1 and COX-2 activities and the suppression was greater in the High EPA group. The results indicate that the combination of fish oil and paracetamol suppresses PGE(2) synthesis by an amount equivalent to that from maximum therapeutic doses of NSAIDs.
CONCLUSION: Paracetamol is recommended for first-line use ahead of NSAIDs for symptom relief in RA or OA. Combining paracetamol with fish oil will enhance suppression of nociceptive PGE(2) synthesis and thereby may provide additive symptomatic benefits.
Authors:
Gillian E Caughey; Michael J James; Susanna M Proudman; Leslie G Cleland
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Complementary therapies in medicine     Volume:  18     ISSN:  1873-6963     ISO Abbreviation:  Complement Ther Med     Publication Date:    2010 Jun-Aug
Date Detail:
Created Date:  2010-08-06     Completed Date:  2011-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9308777     Medline TA:  Complement Ther Med     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  171-4     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Ltd. All rights reserved.
Affiliation:
Quality Use of Medicines and Pharmacy Research Centre (QUMPRC), Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide 5001, Australia. gillian.caughey@unisa.edu.au
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MeSH Terms
Descriptor/Qualifier:
Acetaminophen / pharmacology*,  therapeutic use
Arthritis, Rheumatoid / blood,  drug therapy,  metabolism*
Cyclooxygenase Inhibitors / pharmacology*,  therapeutic use
Dinoprostone / biosynthesis*
Drug Synergism
Eicosapentaenoic Acid / blood,  pharmacology*,  therapeutic use
Humans
Phospholipids / blood,  chemistry
Prostaglandin-Endoperoxide Synthases / blood*
Thromboxane A2 / biosynthesis
Chemical
Reg. No./Substance:
0/Cyclooxygenase Inhibitors; 0/Phospholipids; 103-90-2/Acetaminophen; 1553-41-9/Eicosapentaenoic Acid; 363-24-6/Dinoprostone; 57576-52-0/Thromboxane A2; EC 1.14.99.1/Prostaglandin-Endoperoxide Synthases

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