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From ASA to omega for Crohn’s remission: neither are effective

▸ Feagan BG, Sandborn WJ, Mittmann U, . Omega-3 free fatty acids for the maintenance of Crohn’s disease. The EPIC randomized controlled trials. JAMA 2008;299:1690–7.

There has been interest in the use of omega-3 free fatty acids in maintaining remission in Crohn’s disease since an Italian randomised controlled trial suggested that they were more effective than placebo in 1996. In this paper, two large, well-designed, multicentre, double-blind, placebo-controlled trials of these compounds are reported, EPIC-1 and EPIC-2.

The EPIC-1 study randomised 374 patients with a Crohn’s disease activity index (CDAI) of <150 in remission for between 3 and 12 months with only one disease relapse in the previous year, whilst EPIC-2 included 379 patients with recent disease relapse requiring tapered steroids who achieved a CDAI of <150 after 8 weeks of steroid treatment. Both trials used a total of 4 g of omega-3 free fatty acids per day for 52 and 58 weeks, respectively. The primary outcome was disease relapse, defined as a CDAI >150 at any point during follow-up, an increase in the CDAI of ⩾70, the need for initiation of other medical treatment or the need for surgery. The effect on mean CDAI was also examined in …

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