Omega-3s & Lupus (SLE)

Results of a double-blind randomized and placebo-controlled trial evaluating the use of omega-3 fatty acid supplementation among people with systemic lupus erythematosus (SLE) were recently published in Lupus Science & Medicine. 78 adults (97% women) with active SLE were randomized to receive either control (vegetable oil, including olive, palm kernel, and corn oil) or 4 g per day of krill oil concentrate (KOC). Each gram of KOC provided 322 mg of total omega-3 fatty acids (193 mg EPA and 96 mg DHA), as well as 601 mg of phospholipids (including 558 mg of phosphatidylcholine), for a total daily dose of 1288 mg omega-3s. The randomization period of the study was 24 weeks, followed by an open-label extension period, with the omega-3 index as its primary endpoint and clinical features including the SLE Disease Activity Index 2000 (SLEDAI-2K) as secondary endpoints.

The majority of study participants had a low or intermediate omega-3 index at baseline, including 38% that had levels below 4%, associated with greater cardiovascular disease mortality risk. While no significant change was observed with placebo, KOC supplementation raised the omega-3 index above 4% in all participants, and above 6% in 90% of participants after 24 weeks. Regarding the secondary outcomes, although SLEDAI-2K scores did not change significantly between groups, a subset with more severe disease activity experienced a significant improvement in weeks 4, 8, and 16 compared to placebo (but not at week 24). No other significant differences were observed, other than a lower adverse effect rate in the KOC group. Overall, this study suggests KOC effectively increases the omega-3 index among people with SLE, potentially reducing cardiovascular disease risk and perhaps reducing disease activity among people with more severe SLE, though this has not been conclusively shown.