Association Between Fish Consumption and Minimal Disease Activity in Patients With Rheumatoid Arthritis Receiving Molecular-Targeted Therapies.

AIM: Diet may influence the clinical course of rheumatoid arthritis (RA). Consumption of fish, the main source of n-3 polyunsaturated fatty acids (PUFAs), has been linked to decreased disease activity. We investigated the association between fish intake and disease activity in two different cohorts of RA patients receiving molecular-targeted therapies.

METHODS

This retrospective cross-sectional study included RA patients treated with biologics or Janus kinase inhibitors at Hokkaido University Hospital (Japan) and Virgen de las Nieves Hospital (Spain). Patients completed the validated brief-type self-administered diet history questionnaire (BDHQ, used with permission) and a custom-designed detailed fish frequency questionnaire (DFFQ). Demographic, clinical, and laboratory data were obtained from medical records. Minimal disease activity (MDA) was defined as DAS28-ESR < 2.6 and DAS28-CRP < 2.4. Group comparisons and multivariate logistic regression analyses were performed.

RESULTS

In the Japanese cohort of 205 RA patients, 59% of patients met MDA criteria. Patients with MDA had a higher estimated daily intake of n-3 PUFAs than those with non-MDA. Multivariate logistic regression analysis identified weekly intake of n-3 PUFA-rich fish as an independent factor associated with MDA. In the Spanish RA cohort of 74 patients, 37% met MDA criteria. No significant differences in n-3 PUFA intake or fish consumption were observed between MDA and non-MDA groups.

CONCLUSION

Consumption of n-3 PUFA-rich fish was associated with MDA in patients with RA receiving molecular-targeted therapies.