Marine Oil Supplements for Arthritis Pain: A Systematic Review and Meta-Analysis of Randomized Trials.

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Term Occurence Count Dictionary
arthritis 36 rheumatologydiseases
autoimmune disease 1 rheumatologydiseases
diclofenac 8 rheumatologydiseasesdrugs
naproxen 3 rheumatologydiseasesdrugs
psoriatic arthritis 3 rheumatologydiseases
rheumatoid arthritis 5 rheumatologydiseases
synovitis 2 rheumatologydiseases
indomethacin 1 rheumatologydiseasesdrugs
osteoarthritis 4 rheumatologydiseases

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Select Drug Character Offset Drug Term Instance
diclofenac 30818 dose0.84 + 0.18Kremer et al. 1995 [[61]]66Four-arm, parallel26 or 30RA57.540.910.533 cMO (whole fish), diclofenac , and diclofenac placebo4.29 e + 2.34 e33 cCorn oil, diclofenac, and diclofenac placeboVargová et al.
diclofenac 30834 0.18Kremer et al. 1995 [[61]]66Four-arm, parallel26 or 30RA57.540.910.533 cMO (whole fish), diclofenac, and diclofenac placebo4.29 e + 2.34 e33 cCorn oil, diclofenac, and diclofenac placeboVargová et al. 1998 [[62]]23Two-arm,
diclofenac 30881 30RA57.540.910.533 cMO (whole fish), diclofenac, and diclofenac placebo4.29 e + 2.34 e33 cCorn oil, diclofenac , and diclofenac placeboVargová et al. 1998 [[62]]23Two-arm, parallel21JCA10.1nana13“diet with increased
diclofenac 30897 30RA57.540.910.533 cMO (whole fish), diclofenac, and diclofenac placebo4.29 e + 2.34 e33 cCorn oil, diclofenac, and diclofenac placeboVargová et al. 1998 [[62]]23Two-arm, parallel21JCA10.1nana13“diet with increased content of
diclofenac 33506 dose2.03 e + 1.35 eKremer et al. 1993 [[80]]50Two-arm, parallel26 or 30RAnanana(25) dMO (whole fish), diclofenac , and diclofenac placebo9.75 e,h(25) dCorn oil, diclofenac, and diclofenac placeboLau et al. 1993 [[81],[82]]64Two-arm,
diclofenac 33522 eKremer et al. 1993 [[80]]50Two-arm, parallel26 or 30RAnanana(25) dMO (whole fish), diclofenac, and diclofenac placebo9.75 e,h(25) dCorn oil, diclofenac, and diclofenac placeboLau et al. 1993 [[81],[82]]64Two-arm,
diclofenac 33564 parallel26 or 30RAnanana(25) dMO (whole fish), diclofenac, and diclofenac placebo9.75 e,h(25) dCorn oil, diclofenac , and diclofenac placeboLau et al. 1993 [[81],[82]]64Two-arm, parallel52RA51.470.34.232MO (whole fish)1.71
diclofenac 33580 30RAnanana(25) dMO (whole fish), diclofenac, and diclofenac placebo9.75 e,h(25) dCorn oil, diclofenac, and diclofenac placeboLau et al. 1993 [[81],[82]]64Two-arm, parallel52RA51.470.34.232MO (whole fish)1.71 + 1.1432Air-filled
indomethacin 32181 0.7048Air filled capsuleDas Gupta et al. 2009 [[71]]100Two-arm, parallel12RA47.3nana50MO (whole fish), and indomethacin 1.80 g + 1.20 g50IndomethacinGruenwald et al. 2009 [[72]] (EUCTR200500366918DE)177Two-arm, parallel26Knee/hip
naproxen 34667 2014 [[92]] (IRCT2012102610799N2)114Six-arm, parallel6Knee OAnanana19Omega-3, and acetaminophen and naproxen 1.00 h19Acetaminophen and naproxen19Omega-3 and acetaminophen1.00 h19Acetaminophen19Omega-3 and naproxen1.00
naproxen 34701 (IRCT2012102610799N2)114Six-arm, parallel6Knee OAnanana19Omega-3, and acetaminophen and naproxen1.00 h19Acetaminophen and naproxen 19Omega-3 and acetaminophen1.00 h19Acetaminophen19Omega-3 and naproxen1.00 h19NaproxenAID: anti-inflammatory
naproxen 34771 naproxen1.00 h19Acetaminophen and naproxen19Omega-3 and acetaminophen1.00 h19Acetaminophen19Omega-3 and naproxen 1.00 h19NaproxenAID: anti-inflammatory diet; CVD: cardiovascular disease; DHA: docosahexaenoic acid;
Select Disease Character Offset Disease Term Instance
arthritis 1315 whether marine oil supplements reduce pain and/or improve other clinical outcomes in patients with arthritis . Six databases were searched systematically (24 February 2015). We included randomized trials of oral
arthritis 1485 2015). We included randomized trials of oral supplements of all marine oils compared with a control in arthritis patients. The internal validity was assessed using the Cochrane Risk of Bias tool and heterogeneity
arthritis 2099 −0.42 to −0.07; heterogeneity, I2 = 63%. A significant effect was found in patients with rheumatoid arthritis (22 trials; −0.21; 95% CI, −0.42 to −0.004) and other or mixed diagnoses (3 trials; −0.63; 95%
arthritis 2253 −0.004) and other or mixed diagnoses (3 trials; −0.63; 95% CI, −1.20 to −0.06), but not in osteo arthritis patients (5 trials; −0.17; 95% CI, −0.57–0.24). The evidence for using marine oil to alleviate
arthritis 2372 (5 trials; −0.17; 95% CI, −0.57–0.24). The evidence for using marine oil to alleviate pain in arthritis patients was overall of low quality, but of moderate quality in rheumatoid arthritis patients.1. IntroductionArthritis
arthritis 2457 alleviate pain in arthritis patients was overall of low quality, but of moderate quality in rheumatoid arthritis patients.1. IntroductionArthritis is a musculoskeletal disorder, resulting in joint pain, swelling,
arthritis 2700 [[1],[2]]. In the period 2010–2012, 22.7% of American adults reported having medically-diagnosed arthritis [[3]]. The two most common types of arthritis are rheumatoid arthritis (RA) and osteoarthritis (OA).
arthritis 2746 of American adults reported having medically-diagnosed arthritis [[3]]. The two most common types of arthritis are rheumatoid arthritis (RA) and osteoarthritis (OA). Osteoarthritis is a heterogeneous, degenerative
arthritis 2771 reported having medically-diagnosed arthritis [[3]]. The two most common types of arthritis are rheumatoid arthritis (RA) and osteoarthritis (OA). Osteoarthritis is a heterogeneous, degenerative disease exhibiting inflammatory
arthritis 2795 medically-diagnosed arthritis [[3]]. The two most common types of arthritis are rheumatoid arthritis (RA) and osteo arthritis (OA). Osteoarthritis is a heterogeneous, degenerative disease exhibiting inflammatory components, associated
arthritis 2816 The two most common types of arthritis are rheumatoid arthritis (RA) and osteoarthritis (OA). Osteo arthritis is a heterogeneous, degenerative disease exhibiting inflammatory components, associated with multiple
arthritis 3302 hampering symptom [[7]], and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is substantial across arthritis diagnoses [[8],[9]]. However, NSAIDs are known to cause serious gastrointestinal and occasionally cardiovascular
arthritis 3555 prompting the search for alternative treatments.Marine oil is thought to have an analgesic effect in arthritis as a likely consequence of its high content of docosahexaenoic acid (DHA; 22:6 n-3) and eicosapentaenoic
arthritis 4119 and DHA-rich oil could exert an anti-inflammatory effect [[13]], making it a possible treatment for arthritis pain.Four meta-analyses have compared fish oil or n-3 polyunsaturated fatty acid (PUFA) supplements
arthritis 4906 be produced in the human body [[18],[19]].A previous US survey suggested that approximately 90% of arthritis patients have used, or were using, complementary therapies [[20]]. Therefore, consumers and health care
arthritis 5082 Therefore, consumers and health care practitioners need to know whether oral marine oil can reduce arthritis pain.The aim of this systematic review was to evaluate the effect of marine oil across a broad range
arthritis 6903 mussels) with a control treatment applying an add-on design in patients diagnosed with any type of arthritis for a minimum duration of two weeks. No restrictions were applied on age or gender of the participants,
arthritis 10742 average for pain of 60 mm on a 100-mm visual analog scale (VAS) with an SD of 20 mm based on a cohort of arthritis patients [[33]]. For inflammation, a baseline value of 3.8 mg/dL CRP and an SD of 5.9 mg/dL were assumed
arthritis 14976 oil. Thirty-two trials examined RA, 6 trials examined OA, and 4 trials examined other/mixed types of arthritis (juvenile arthritis, number of trials: k = 1; polyarticular psoriatic arthritis, k = 1; mixed diagnoses
arthritis 14996 trials examined RA, 6 trials examined OA, and 4 trials examined other/mixed types of arthritis (juvenile arthritis , number of trials: k = 1; polyarticular psoriatic arthritis, k = 1; mixed diagnoses of RA and/or OA,
arthritis 15056 other/mixed types of arthritis (juvenile arthritis, number of trials: k = 1; polyarticular psoriatic arthritis , k = 1; mixed diagnoses of RA and/or OA, k = 1; mixed diagnoses of RA or psoriatic arthritis, k = 1).
arthritis 15149 psoriatic arthritis, k = 1; mixed diagnoses of RA and/or OA, k = 1; mixed diagnoses of RA or psoriatic arthritis , k = 1). The trials included 2751 patients with a mean age of 53.8 years (range of mean age of 10–68
arthritis 21743 3.4. DiscussionThe present systematic review and meta-analysis indicated an effect of marine oil on arthritis , although with a considerable heterogeneity across the studies. Twenty-two trials (N = 956) with complete
arthritis 22184 oil in patients with OA, and only three trials (N = 150) assessed the effect in patients with other arthritis diagnoses; we rated the evidence to be of low grade for both patient groups. Hence, the evidence was
arthritis 22520 OA and other/mixed diagnosis groups were highly heterogeneous (I2 = 82% and 89%, respectively). Osteo arthritis has varying degrees of inflammation [[4]]; hence, in the future it might be appropriate to distinguish
arthritis 26299 is the first comprehensive systematic review and meta-analysis regarding the effect of marine oil on arthritis . In contrast to previous meta-analyses [[14],[15],[16],[17]], we included all types of arthritis, all
arthritis 26396 on arthritis. In contrast to previous meta-analyses [[14],[15],[16],[17]], we included all types of arthritis , all types of marine oil (i.e., oils of any marine origin), and did not include vegetable sources of
arthritis 26720 this meta-analysis suggests a small favorable effect of marine oil in reducing pain in patients with arthritis (SMD < −0.2) [[97]], but the evidence was of low quality. There is moderate quality evidence for an
arthritis 27122 to provide evidence for firm conclusions regarding the effect of marine oil in OA and other types of arthritis , but also regarding the optimal dose, ratio of EPA and DHA, and which type of marine oil is preferable.
arthritis 35067 gamma-linolenic acid; GLM: green-lipped mussel; HMLE: hard-shelled mussel lipid extract; JCA: juvenile chronic arthritis ; MO: marine oil; MUFA: monounsaturated fatty acid; N: number; na: not available; NSAID: nonsteroidal
arthritis 35212 monounsaturated fatty acid; N: number; na: not available; NSAID: nonsteroidal anti-inflammatory drugs, OA: osteo arthritis ; p.a. PSA: polyarticular psoriatic arthritis; PUFA: polyunsaturated fatty acid; RA: rheumatoid arthritis;
arthritis 35257 NSAID: nonsteroidal anti-inflammatory drugs, OA: osteoarthritis; p.a. PSA: polyarticular psoriatic arthritis ; PUFA: polyunsaturated fatty acid; RA: rheumatoid arthritis; WD: western diet; WO: wash out; Note that
arthritis 35317 osteoarthritis; p.a. PSA: polyarticular psoriatic arthritis; PUFA: polyunsaturated fatty acid; RA: rheumatoid arthritis ; WD: western diet; WO: wash out; Note that the use of the term MO refers to all oils of marine origin
arthritis 41088 July 8, 2015. McMaster University, 2014; 95% CI: 95% confidence interval, MO: marine oil, OA: osteo arthritis , RA: rheumatoid arthritis, RR: relative risk, SMD: standardized mean difference. Note that the use of
arthritis 41114 University, 2014; 95% CI: 95% confidence interval, MO: marine oil, OA: osteoarthritis, RA: rheumatoid arthritis , RR: relative risk, SMD: standardized mean difference. Note that the use of the term MO refers to all
arthritis 42192 the heterogeneity could be explained for function. When doing separate analyses according to type of arthritis , the heterogeneity was 32%, 82%, and 89% for RA, OA and “other”, respectively. For the two latter,
autoimmune disease 2970 exhibiting inflammatory components, associated with multiple risk factors [[4]]. In contrast, RA is an autoimmune disease involving higher levels of synovitis (joint inflammation) than OA [[2],[4]]. The extent of synovitis
osteoarthritis 2248 −0.004) and other or mixed diagnoses (3 trials; −0.63; 95% CI, −1.20 to −0.06), but not in osteoarthritis patients (5 trials; −0.17; 95% CI, −0.57–0.24). The evidence for using marine oil to alleviate
osteoarthritis 2790 medically-diagnosed arthritis [[3]]. The two most common types of arthritis are rheumatoid arthritis (RA) and osteoarthritis (OA). Osteoarthritis is a heterogeneous, degenerative disease exhibiting inflammatory components, associated
osteoarthritis 35207 monounsaturated fatty acid; N: number; na: not available; NSAID: nonsteroidal anti-inflammatory drugs, OA: osteoarthritis ; p.a. PSA: polyarticular psoriatic arthritis; PUFA: polyunsaturated fatty acid; RA: rheumatoid arthritis;
osteoarthritis 41083 version July 8, 2015. McMaster University, 2014; 95% CI: 95% confidence interval, MO: marine oil, OA: osteoarthritis , RA: rheumatoid arthritis, RR: relative risk, SMD: standardized mean difference. Note that the use of
psoriatic arthritis 15046 examined other/mixed types of arthritis (juvenile arthritis, number of trials: k = 1; polyarticular psoriatic arthritis , k = 1; mixed diagnoses of RA and/or OA, k = 1; mixed diagnoses of RA or psoriatic arthritis, k = 1).
psoriatic arthritis 15139 polyarticular psoriatic arthritis, k = 1; mixed diagnoses of RA and/or OA, k = 1; mixed diagnoses of RA or psoriatic arthritis , k = 1). The trials included 2751 patients with a mean age of 53.8 years (range of mean age of 10–68
psoriatic arthritis 35247 available; NSAID: nonsteroidal anti-inflammatory drugs, OA: osteoarthritis; p.a. PSA: polyarticular psoriatic arthritis ; PUFA: polyunsaturated fatty acid; RA: rheumatoid arthritis; WD: western diet; WO: wash out; Note that
rheumatoid arthritis 2088 interval, CI, −0.42 to −0.07; heterogeneity, I2 = 63%. A significant effect was found in patients with rheumatoid arthritis (22 trials; −0.21; 95% CI, −0.42 to −0.004) and other or mixed diagnoses (3 trials; −0.63; 95%
rheumatoid arthritis 2446 oil to alleviate pain in arthritis patients was overall of low quality, but of moderate quality in rheumatoid arthritis patients.1. IntroductionArthritis is a musculoskeletal disorder, resulting in joint pain, swelling,
rheumatoid arthritis 2760 adults reported having medically-diagnosed arthritis [[3]]. The two most common types of arthritis are rheumatoid arthritis (RA) and osteoarthritis (OA). Osteoarthritis is a heterogeneous, degenerative disease exhibiting inflammatory
rheumatoid arthritis 35306 osteoarthritis; p.a. PSA: polyarticular psoriatic arthritis; PUFA: polyunsaturated fatty acid; RA: rheumatoid arthritis ; WD: western diet; WO: wash out; Note that the use of the term MO refers to all oils of marine origin
rheumatoid arthritis 41103 McMaster University, 2014; 95% CI: 95% confidence interval, MO: marine oil, OA: osteoarthritis, RA: rheumatoid arthritis , RR: relative risk, SMD: standardized mean difference. Note that the use of the term MO refers to all
synovitis 3016 with multiple risk factors [[4]]. In contrast, RA is an autoimmune disease involving higher levels of synovitis (joint inflammation) than OA [[2],[4]]. The extent of synovitis has been shown to be associated with
synovitis 3080 disease involving higher levels of synovitis (joint inflammation) than OA [[2],[4]]. The extent of synovitis has been shown to be associated with pain severity [[5],[6]]. Arthritis patients consider pain the most

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