Abstract:
ABSTRACT
Background: Blood cell aggregation and adherence to vascular
endothelium and inflammation play a central role in vaso-occlusive
crisis in sickle cell disease. The antiaggregatory, antiadhesive, antiinflammatory, and vasodilatory omega-3 (n23) fatty acids (DHA
and EPA) are significantly reduced in patients with the disease.
Objective: The aim was to investigate the therapeutic potential of
omega-3 fatty acids for patients with homozygous sickle cell disease in a randomized, placebo-controlled, double-blind trial.
Design: One hundred forty patients recruited from a single center in
Sudan were randomly assigned and received, daily, 1 (age 2–4 y), 2
(age 5–10 y), 3 (age 11–16), or 4 (age $17 y) omega-3 capsules
containing 277.8 mg DHA and 39.0 mg EPA or placebo for 1 y. Of
these patients, 128 were followed up and the data were obtained. The
primary and secondary endpoints—rates of clinical vaso-occlusive
crisis and hemolytic events, blood transfusion rate, school attendance, and blood count—were analyzed by intention-to-treat analysis (n = 140).
Results: Omega-3 treatment reduced the median rate of clinical
vaso-occlusive events (0 compared with 1.0 per year, P ,
0.0001), severe anemia (3.2% compared with 16.4%; P , 0.05),
blood transfusion (4.5% compared with 16.4%; P , 0.05), white
blood cell count (14.4 6 3.3 compared with 15.6 6 4.0 3103/mL; P
, 0.05), and the OR of the inability to attend school at least once
during the study period because of illness related to the disease to
0.4 (95% CI: 0.2, 0.9; P , 0.05).
