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Omega-3 reduced pancreas transplant failure by 3X and sepsis by 2X – review Dec 2019

Are omega-3 fatty acids safe and effective in acute pancreatitis or sepsis? A systematic review and meta-analysis

Clinical Nutrition DOI: https://doi.org/10.1016/j.clnu.2019.12.006
Daniel R.J. Wolbrinka,∗,'Correspondence information about the author Daniel R.J. WolbrinkEmail the author Daniel R.J. Wolbrink, Jessica R. Grundsellb, Ben Wittemanc, Marcel van de Polld, Hjalmar C.van Santvoorte,f, Eyad Issag, Ashley Dennisong, Harry van Goora, Marc G. Besselinkb,1, Stefan A.W. Bouwensea,1 the Dutch Pancreatitis Study Group

Acute pancreatitis (AP) is marked by a strong pro-inflammatory response, which may cause a systemic inflammatory response syndrome (SIRS), organ failure, and death. Early administration of omega-3 fatty acids (FA) may reduce the pro-inflammatory response and improve outcome in AP. A systematic review focusing on the safety and efficacy of omega-3 FA in AP is lacking.

Aim: Evaluate the safety and efficacy of an intervention with omega-3 FA in acute pancreatitis and sepsis.

A systematic review and meta-analysis was performed using the PubMed, Embase, and Cochrane databases including only randomized controlled trials in AP and, for safety endpoints, in sepsis investigating intervention including omega-3 FA without other active components (e.g. addition of glutamine to the intervention). The primary outcome was mortality.

After screening 1186 studies, five randomized trials (n = 229) with omega-3 FA in AP were included. In AP patients treated with omega-3 FA within 48 h after hospitalization, a non-significant reduction of mortality was seen (OR 0∙50, 95%CI 0∙13–1∙99, p = 0∙33), compared to controls. In two studies (n = 85), omega-3 FA reduced the risk of new onset of organ failure (OR 0∙33, 95%CI 0∙12–0∙93, p = 0∙04). Nine randomized trials with 312 patients suffering from sepsis (not pancreatitis related) demonstrated a reduced mortality (OR 0∙52, 95%CI 0∙28–0∙97, p = 0·04). None of these 14 randomized trials reported safety concerns.

Administration of omega-3 FA could reduce the risk of new-organ failure in patients with AP. There were no safety issues reported of the early administration of omega-3 FA in any of the included studies. To show the real clinical benefit of omega-3 FA in AP, a large and pragmatic randomized controlled trial is needed.

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