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Omega-3 shows no benefit for obese pediatric asthma control

Monday, January 28, 2019
By Kevin Kunzmann
Jason Lang, MD, MPH

Omega-3 fatty acid supplementation—a therapy suggested to benefit cardiovascular, neurologic, inflammatory, and other indications—has no positive effect on asthma control in adolescent and pediatric patients.

In a new study assessing the supplementation in overweight/obese patients with uncontrolled asthma aged 12 to 25 years old, a team of investigators, led by Jason E. Lang, MD, MPH, of the Duke Children’s Hospital and Health Center, Duke University School of Medicine, found they could not recommend omega-3 fatty acid (n3PUFA) as a preventive measure.

“These findings do not support a strategy of therapeutic n3PUFA supplementation in these patients with symptomatic asthma,” they wrote.

Study authors did not respond to a request for comment at the time of publication. In a statement regarding the results, Lang noted that growing evidence pointing to systemic inflammation being caused by an asthmatic patient’s obesity.

“Because the omega-3 fatty acids in fish oil have anti-inflammatory properties, we wanted to test whether fish oil would have therapeutic benefits for these patients,” Lang said.

In a multi-center trial, 98 participants were randomized 3:1 to receive either 4g n3PUFA daily (n= 77) or soy oil control (21) for 24 weeks. Using the Asthma Control Questionnaire (ACQ) to assess asthma control metrics, investigators also monitored patient exacerbations, forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1).

Approximately 86% of participants had completed their physician visits during the trial period. Participants on both fish oil and soy oil reported similar mean change in ACQ score at 6 months (-0.09 vs -0.18, respectively). Additionally, urinary leukotriene-E (uLTE) levels were similar (P= .24), as were predicted FEV1 percentages (P= .88), and exacerbations (RR= .92; 95% CI: 0.30-2.89), at 24 weeks.

With consideration to the role of a variant in gene ALOX5 in the study’s findings, investigators found no association. Gene mutations are capable of reducing the body’s response to anti-leuoktriene drugs, which work to combat inflammatory molecules behind asthma attacks. Though the ALOX5 variant was linked to patients’ leukotriene production, it did not influence the fish oil treatment’s efficacy.

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