In cystic fibrosis, what is the evidence for omega-3 supplementation?

• A. It has consistently improved outcomes across trials
• B. Results have been mixed; more trials needed
• C. It is contraindicated
• D. It is standard care

Answer: (B)

Evidence for omega-3 supplementation in CF is mixed and not yet conclusive. Omega-3 fatty acids have anti-inflammatory properties, which could theoretically help in CF where chronic airway inflammation contributes to decline in lung function and nutrition. Across trials and studies, results have varied: some small trials show reductions in inflammatory markers and occasional modest improvements in weight or lung function, but many trials find no significant benefit on key outcomes such as FEV1, frequency of pulmonary exacerbations, hospitalization, or growth. The inconsistencies come from differences in study design—varying doses and formulations (EPA/DHA), duration of therapy, age groups, baseline nutritional/inflammatory status, and concurrent treatments. Because no consistent, reproducible benefit has emerged, omega-3 supplementation cannot be considered standard care, and more robust, adequately powered trials are needed to define potential benefit, optimal dosing, and which patients might benefit most. Safety is generally acceptable but high-dose omega-3 can increase bleeding risk and interact with anticoagulants, so monitoring is prudent until clearer guidance is available.