{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T05:25:43Z","timestamp":1792301143236,"version":"4.4.0"},"reference-count":48,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,1,29]],"date-time":"2018-01-29T00:00:00Z","timestamp":1517184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate potential associations between dietary intake of polyunsaturated fatty acids (FAs) and pain patterns in early rheumatoid arthritis (RA) patients after 3 months of methotrexate (MTX) treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included 591 early RA patients with MTX monotherapy from a population\u2010based prospective case\u2013control study, the Epidemiological Investigation of Rheumatoid Arthritis. Dietary data on polyunsaturated FAs (food frequency questionnaires) were linked with data on unacceptable pain (visual analog scale [VAS] &gt;40 mm), noninflammatory\/refractory pain (VAS &gt;40 mm and C\u2010reactive protein [CRP] level &lt;10 mg\/liter), and inflammatory pain (VAS &gt;40 mm and CRP level &gt;10 mg\/liter) after 3 months. Statistical analysis included logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After 3 months of MTX treatment, 125 patients (21.2%) had unacceptable pain, of which 92 patients had refractory pain, and 33 patients had inflammatory pain. Omega\u20103 FA intake was inversely associated with unacceptable pain and refractory pain (odds ratio [OR] 0.57 [95% confidence interval (95% CI) 0.35\u20130.95] and OR 0.47 [95% CI 0.26\u20130.84], respectively). The omega\u20106:omega\u20103 FA ratio, but not omega\u20106 FA alone, was directly associated with unacceptable pain and refractory pain (OR 1.70 [95% CI 1.03\u20132.82] and OR 2.33 [95% CI 1.28\u20134.24], respectively). Furthermore, polyunsaturated FAs were not associated with either inflammatory pain or CRP level and erythrocyte sedimentation rate at followup. Omega\u20103 FA supplementation was not associated with any pain patterns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Omega\u20103 FA was inversely associated with, and the omega\u20106:omega\u20103 FA ratio was directly associated with, unacceptable and refractory pain, but not with inflammatory pain or systemic inflammation. The inverse association between omega\u20103 FA and refractory pain may have a role in pain suppression in RA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23245","type":"journal-article","created":{"date-parts":[[2017,3,28]],"date-time":"2017-03-28T15:54:51Z","timestamp":1490716491000},"page":"205-212","source":"Crossref","is-referenced-by-count":37,"title":["Dietary Intake of Polyunsaturated Fatty Acids and Pain in Spite of Inflammatory Control Among Methotrexate\u2010Treated Early Rheumatoid Arthritis Patients"],"prefix":"10.1002","volume":"70","author":[{"given":"Cecilia","family":"Lourdudoss","sequence":"first","affiliation":[{"name":"Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Di Giuseppe","sequence":"additional","affiliation":[{"name":"Karolinska Institutet Stockholm 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