424 Little benefit from omega-3 fatty acids for intermittent claudication

May 11, 2014

PEARLS 424, March 2014, written by Brian R McAvoy

Clinical question
How effective is omega-3 supplementation in people with intermittent claudication?

Bottom line
There was no evidence of consistently improved haematological results (triglycerides, total cholesterol, HDL, VLDL or LDL-cholesterol levels) or clinical outcomes (quality of life, pain-free or maximal walking distance, blood pressure, mortality, vascular events, ankle brachial pressure index or angiographic findings). There was some limited evidence that blood, but not plasma viscosity levels, decreased with treatment. Adverse effects, such as nausea, diarrhoea and flatulence, were observed in 2 studies.

Caveat
The studies were statistically and clinically heterogeneous in terms of dose, duration of therapy and placebo used. None of the studies used an inactive placebo. The duration of the studies ranged from 7 weeks to 2 years.

Context
Omega-3 fatty acids have been used in the treatment and prevention of coronary artery disease although current evidence suggests they may be of limited benefit. Peripheral arterial disease and coronary artery disease share a similar pathogenesis, so omega-3 fatty acids may have a similar effect on both conditions.

Cochrane Systematic Review
Campbell A, Price J, Hiatt WR. Omega-3 fatty acids for intermittent claudication. Cochrane Reviews, 2013, Issue 7. Art. No.: CD003833.DOI: 10.1002/14651858. CD003833.pub4. This review contains 9 studies involving 425 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.