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Study flow diagram (up to March 2006).
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Figure 1

Study flow diagram (up to March 2006).

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PRISMA flowchart (2006‐17 November 2011).
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Figure 2

PRISMA flowchart (2006‐17 November 2011).

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 4

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Comparison 1 PUFAs: spread with linoleic acid (11 to 23 g/day) compared to oleic acid, Outcome 1 Number of patient with disease progression after 24 months.
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Analysis 1.1

Comparison 1 PUFAs: spread with linoleic acid (11 to 23 g/day) compared to oleic acid, Outcome 1 Number of patient with disease progression after 24 months.

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Comparison 1 PUFAs: spread with linoleic acid (11 to 23 g/day) compared to oleic acid, Outcome 2 Number of patients experiencing relapses.
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Analysis 1.2

Comparison 1 PUFAs: spread with linoleic acid (11 to 23 g/day) compared to oleic acid, Outcome 2 Number of patients experiencing relapses.

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Comparison 1 PUFAs: spread with linoleic acid (11 to 23 g/day) compared to oleic acid, Outcome 3 Relapse rate at 24 months.
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Analysis 1.3

Comparison 1 PUFAs: spread with linoleic acid (11 to 23 g/day) compared to oleic acid, Outcome 3 Relapse rate at 24 months.

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Comparison 2 PUFAs: capsules with linoleic acid (2.9 to 3.4 g/day) compared to oleic acid, Outcome 1 Number of Chronic‐Progressive patients with disease progression after 24 months.
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Analysis 2.1

Comparison 2 PUFAs: capsules with linoleic acid (2.9 to 3.4 g/day) compared to oleic acid, Outcome 1 Number of Chronic‐Progressive patients with disease progression after 24 months.

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Comparison 2 PUFAs: capsules with linoleic acid (2.9 to 3.4 g/day) compared to oleic acid, Outcome 2 Number of Relapsing‐Remitting patients with one or more relapses after 24 months.
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Analysis 2.2

Comparison 2 PUFAs: capsules with linoleic acid (2.9 to 3.4 g/day) compared to oleic acid, Outcome 2 Number of Relapsing‐Remitting patients with one or more relapses after 24 months.

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Comparison 2 PUFAs: capsules with linoleic acid (2.9 to 3.4 g/day) compared to oleic acid, Outcome 3 Relapse rate after 24 months in relapsing‐remitting patients.
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Analysis 2.3

Comparison 2 PUFAs: capsules with linoleic acid (2.9 to 3.4 g/day) compared to oleic acid, Outcome 3 Relapse rate after 24 months in relapsing‐remitting patients.

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Comparison 3 PUFAs: fish oil capsules with eicosapentaenoic acid + docosaexanoid acid (omega‐3 fatty acid) compared to oleic acid for RRMS patients, Outcome 1 Number of patients with disease progression.
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Analysis 3.1

Comparison 3 PUFAs: fish oil capsules with eicosapentaenoic acid + docosaexanoid acid (omega‐3 fatty acid) compared to oleic acid for RRMS patients, Outcome 1 Number of patients with disease progression.

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Comparison 3 PUFAs: fish oil capsules with eicosapentaenoic acid + docosaexanoid acid (omega‐3 fatty acid) compared to oleic acid for RRMS patients, Outcome 2 Number of patients with one or more relapses after 12 months.
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Analysis 3.2

Comparison 3 PUFAs: fish oil capsules with eicosapentaenoic acid + docosaexanoid acid (omega‐3 fatty acid) compared to oleic acid for RRMS patients, Outcome 2 Number of patients with one or more relapses after 12 months.

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Comparison 1. PUFAs: spread with linoleic acid (11 to 23 g/day) compared to oleic acid

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number of patient with disease progression after 24 months Show forest plot

2

144

Risk Ratio (M‐H, Fixed, 95% CI)

1.04 [0.66, 1.63]

2 Number of patients experiencing relapses Show forest plot

2

541

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.74, 1.13]

2.1 no relapses

2

132

Risk Ratio (M‐H, Fixed, 95% CI)

1.13 [0.58, 2.19]

2.2 1‐2 relapses

2

132

Risk Ratio (M‐H, Fixed, 95% CI)

1.37 [0.94, 1.98]

2.3 3 or more relapses

2

132

Risk Ratio (M‐H, Fixed, 95% CI)

0.61 [0.38, 0.96]

2.4 3 or more relapses ‐ Sensitivity analysis

2

145

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.52, 1.09]

3 Relapse rate at 24 months Show forest plot

1

WMD (Fixed, 95% CI)

0.83 [0.62, 1.12]
Figuras y tablas -
Comparison 1. PUFAs: spread with linoleic acid (11 to 23 g/day) compared to oleic acid
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Comparison 2. PUFAs: capsules with linoleic acid (2.9 to 3.4 g/day) compared to oleic acid

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number of Chronic‐Progressive patients with disease progression after 24 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2 Number of Relapsing‐Remitting patients with one or more relapses after 24 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3 Relapse rate after 24 months in relapsing‐remitting patients Show forest plot

1

rr (Fixed, 95% CI)

Totals not selected
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Comparison 2. PUFAs: capsules with linoleic acid (2.9 to 3.4 g/day) compared to oleic acid
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Comparison 3. PUFAs: fish oil capsules with eicosapentaenoic acid + docosaexanoid acid (omega‐3 fatty acid) compared to oleic acid for RRMS patients

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number of patients with disease progression Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 After 12 months

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 After 12 months ‐ Sensitivity analysis

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 After 24 months

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Number of patients with one or more relapses after 12 months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 3. PUFAs: fish oil capsules with eicosapentaenoic acid + docosaexanoid acid (omega‐3 fatty acid) compared to oleic acid for RRMS patients
Ir a la tabla de la revisión