A double‐blind, randomized, placebo‐controlled trial of essential fatty acid supplementation in the maintenance of remission of ulcerative colitis

Summary Background : Essential fatty acid supplementation has been found to ameliorate certain chronic inflammatory diseases. This effect is thought to be mediated through the modulation of eicosanoid synthesis. Pro‐inflammatory eicosanoids have been implicated in ulcerative colitis. Aim : To investigate the possible therapeutic benefit of essential fatty acids in quiescent ulcerative colitis to reduce the frequency of disease relapse. Methods : A randomized, double‐blind, placebo‐controlled study was performed with a treatment duration of 12 months. Patients with quiescent disease received either trial medication (gamma‐linolenic acid, 1.6 g, eicosapentaenoic acid, 270 mg, and docosahexaenoic acid, 45 mg, per day) or placebo (sunflower oil, 500 mg/day). The primary end‐point was disease activity, assessed by a previously validated clinical index, sigmoidoscopic appearance and histology. Results : Sixty‐three patients were randomized, 31 to receive essential fatty acid treatment and 32 to receive placebo. Disease relapse rates were similar at 12 months (placebo, 38%; essential fatty acids, 55%), as were changes in sigmoidoscopic grade from baseline. Conclusions : The supplementation of the diet with this combination of essential fatty acids does not prolong the period of disease remission of ulcerative colitis.