N Engl J Med. 1996 Jun 13;334(24):1557-60.  

Effect of an enteric-coated fish-oil preparation on relapses in Crohn's disease.

Belluzzi A, Brignola C, Campieri M, Pera A, Boschi S, Miglioli M.

Institute of Clinical Medicine and Gastroenterology, University of Bologna,

Italy.

BACKGROUND: Patients with Crohn's disease may have periods of remission,

interrupted by relapses. Because fish oil has antiinflammatory actions, it could

reduce the frequency of relapses, but it is often poorly tolerated because of

its unpleasant taste and gastrointestinal side effects. METHODS: We performed a

one-year, double-blind, placebo-controlled study to investigate the effects of a

new fish-oil preparation in the maintenance of remission in 78 patients with

Crohn's disease who had a high risk of relapse. The patients received either

nine fish-oil capsules containing a total of 2.7 g of n-3 fatty acids or nine

placebo capsules daily. A special coating protected the capsules against gastric

acidity for at least 30 minutes. RESULTS: Among the 39 patients in the fish-oil

group, 11 (28 percent) had relapses, 4 dropped out because of diarrhea, and 1

withdrew for other reasons. In contrast, among the 39 patients in the placebo

group, 27 (69 percent) had relapses, 1 dropped out because of diarrhea, and 1

withdrew for other reasons (difference in relapse rate, 41 percentage points; 95

percent confidence interval, 21 to 61; P < 0.001). After one year, 23 patients

(59 percent) in the fish-oil group remained in remission, as compared with 10

(26 percent) in the placebo group (P = 0.003). Logistic-regression analysis

indicated that only fish oil and not sex, age, previous surgery, duration of

disease, or smoking status affected the likelihood of relapse (odds ratio for

the placebo group as compared with the fish-oil group, 4.2; 95 percent

confidence interval, 1.6 to 10.7). CONCLUSIONS: In patients with Crohn's disease

in remission, a novel enteric-coated fish-oil preparation is effective in

reducing the rate of relapse.