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Efficacy of ethyl-EPA as a treatment for Huntington disease: a systematic review and meta-analysis

Published online by Cambridge University Press:  19 June 2019

Sara Morsy ,
Samar Morsy Khalil ,
Mohamed Fahmy Doheim ,
Mohamed Gomaa Kamel ,
Doaa Saeed Mahmoud El-Basiony ,
Hossam Idrees Ahmed Hassan ,
Ahmed Abdelaziz Eisa ,
Cao Thị Anh Ngoc ,
Nguyen Phu Dang  and
Kenji Hirayama
...Show all authors
Sara Morsy
Affiliation:
Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Tanta University, Tanta, Egypt Nagasaki University, Nagasaki, Japan (http://www.onlineresearchclub.org)
Samar Morsy Khalil
Affiliation:
Nagasaki University, Nagasaki, Japan (http://www.onlineresearchclub.org) National Institute of Neuromotor System, Cairo, Egypt
Mohamed Fahmy Doheim
Affiliation:
Nagasaki University, Nagasaki, Japan (http://www.onlineresearchclub.org) Faculty of Medicine, Alexandria University, Alexandria, Egypt
Mohamed Gomaa Kamel
Affiliation:
Nagasaki University, Nagasaki, Japan (http://www.onlineresearchclub.org) Faculty of Medicine, Minia University, Minia, Egypt
Doaa Saeed Mahmoud El-Basiony
Affiliation:
Nagasaki University, Nagasaki, Japan (http://www.onlineresearchclub.org) Faculty of Medicine, Menoufia University, Menoufia, Egypt
Hossam Idrees Ahmed Hassan
Affiliation:
Nagasaki University, Nagasaki, Japan (http://www.onlineresearchclub.org) Faculty of Medicine, Assiut University, Assiut, Egypt
Ahmed Abdelaziz Eisa
Affiliation:
Nagasaki University, Nagasaki, Japan (http://www.onlineresearchclub.org) Faculty of Medicine, Alexandria University, Alexandria, Egypt
Cao Thị Anh Ngoc
Affiliation:
Nagasaki University, Nagasaki, Japan (http://www.onlineresearchclub.org) University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
Nguyen Phu Dang
Affiliation:
Nagasaki University, Nagasaki, Japan (http://www.onlineresearchclub.org) University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
Kenji Hirayama
Affiliation:
Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Leading Graduate School Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
Nguyen Tien Huy*
Affiliation:
Evidence-Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
*
Author for correspondence: Nguyen Tien Huy, Email: nguyentienhuy@tdtu.edu.vn
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Abstract

Objective:

After MRI studies suggested the efficacy of ethyl-EPA in reducing the progressive brain atrophy in Huntington disease (HD), trials were conducted to test its efficacy as a treatment for HD. Trials that continued for 6 months did not find any significant improvement, urging discontinuation of the drug. However, trials that continued for 12 months indicated improvement of motor functions in these patients.

Methods:

We searched 12 electronic databases to find randomised clinical trials relevant to our inclusion criteria. After screening, only five papers were included. Continuous and binary variables were analysed to compute the pooled mean difference (MD) and risk ratio (RR), respectively. Quality effect model meta-analysis was used as a post hoc analysis for studies at 12 months.

Findings:

Meta-analysis indicated that ethyl-eicosapentaenoic acid (EPA) has no significant effect on any scale of HD at 6 months. At 12 months, two studies suggested significant improvements of the Total Motor Score and Total Motor Score–4 in both fixed and quality effect models [MD = −2.720, 95% CI (−4.76, –.68), p = 0.009; MD = −2.225, 95% CI (−3.842, −0.607), p = 0.007], respectively. Maximal chorea score showed significant results [MD = −1.013, 95% CI (−1.793, −0.233), p = 0.011] in only fixed-effect model, while no improvement was detected for Stroop colour naming test or symbol digit modality.

Conclusion:

Meta-analysis indicated a significant improvement of motor scores only after 12 months. These results should be interpreted cautiously because only two studies had assessed the efficacy of ethyl-EPA after 12 months with one of them having a 6-month open-label phase.

Keywords

Huntington diseasechoreaeicosapentaenoic acidomega-3 fatty acids
Type
Review Article
Information
Acta Neuropsychiatrica , Volume 31 , Issue 4 , August 2019 , pp. 175 - 185
Copyright
© Scandinavian College of Neuropsychopharmacology 2019 

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