Omega-3 free fatty acids supplements do not appear to prevent relapse in Crohn's disease patients, a study shows.

A team at the University of Western Ontario conducted two large-scale trials of high-dose omega-3 free fatty acids as maintenance therapy in patients with Crohn's disease in remission.

The studies, Epanova Program in Crohn's Study 1 (EPIC-1) and EPIC-2, were carried out at 98 centres in Canada, Europe, Israel and the US.

Patients were randomly assigned either 4 g of omega-3 free fatty acids or placebo for up to 58 weeks.

Some 188 EPIC-1 patients received omega-3 free fatty acids and 186 patients received placebo, while 189 patients received omega-3 free fatty acids and 190 received placebo in the EPIC-2 study.

No significant difference in relapse rates was found between the two groups in either trial, with 54 patients treated with omega-3 free fatty acids and 62 patients receiving placebo experiencing a clinical relapse in EPIC-1. In the EPIC-2 group 84 patients experienced relapse (compared with 94 patients treated with placebo).

In EPIC-1 31.6 per cent of patients receiving omega-3 free fatty acids experienced a relapse within 360 days (compared with 35.7 per cent in the placebo group), while in EPIC-2 this was 47.8 per cent (compared with 48.8 per cent of placebo patients).

The study's authors claimed that the results were important as the use of alternative medicines and omega-3 free fatty acid formulations is widespread among patients with inflammatory bowel disease.

"Given the negative results observed in the EPIC trials and in [other trials], we do not endorse this practice, since patients with Crohn's disease who are at risk for relapse would be better served by taking medications of known efficacy," they concluded.

Previous clinical trials to evaluate omega-3 free fatty acids for maintenance of remission in Crohn's disease have hitherto been inconsistent.

The study is reported in the April 9th issue of JAMA.

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