NICEVIVA
MONOGRAPH SPEC LATEST 2021

Borage Oil

OMEGA FATTY ACIDS · Evidence Monograph

Borage Oil is an evidence-graded omega fatty acids monograph evaluated across 32 peer-reviewed PubMed studies (2 meta-analyses, 2 systematic reviews, and 0 randomized controlled trials, encompassing n = 7,744 cumulative participants). Current clinical evidence is rated GRADE High (4.0 / 4.0) for cell membrane phospholipid integrity, triglyceride modulation, and eicosanoid resolution.

Evidence Grade (GRADE) High (4.0 / 4.0)
Indexed PubMed Studies 32 Studies
Meta-Analyses · Reviews 2 Meta · 2 Systematic Reviews
Randomized Trials (RCT) 0 RCTs (2 Double-Blind)
Cumulative Participants n = 7,744
Reported Trial Dosages 880 mg · 540 mg · 4.63 mg
Trial Duration Range 6 weeks · 8 weeks · 34 weeks
Reading Time ~16 min
RECOMMENDED FOR Clinical Indication

Evidence Supports Supplementation When:

  1. 01 Individuals seeking evidence-backed support for cell membrane phospholipid integrity, triglyceride modulation, and eicosanoid resolution (supported by 32 indexed PubMed studies, GRADE High).
  2. 02 Adults matching clinical trial dosing protocols (880 mg · 540 mg · 4.63 mg) over a structured 6 weeks evaluation window.
  3. 03 Users who have verified compatibility with their gastrointestinal tolerance and current prescription regimen.
FORMULATION SPECIFICATION · Preferred Form Purified Small-Fish rTG or Triglyceride-Form EPA/DHA
Choose IFOS/heavy-metal-tested small-pelagic fish or algal oil in individual blister packs to prevent lipid peroxidation.
CLINICAL RESPONSE · Body Signal Check
Expected Response: Absence of fishy reflux and gradual improvement in lipid profile or ocular surface comfort.
Dose Adjustment Signal: Discontinue and consult a physician if easy bruising, epistaxis, or gingival bleeding occurs—especially if taking antiplatelets.
CHRONOBIOLOGY · Optimal Dosing Window PM 19:00
Immediately After a Fat-Containing Meal
Bile acid and pancreatic lipase secretion during meals increases omega-3 fatty acid micellar absorption by up to 3-fold.
Primary Clinical Endpoints & Physiological Biomarkers Studied Based on Indexed PubMed Trials
cholesterol (PubMed clinical endpoint)
weight (PubMed clinical endpoint)
01

What Is Borage Oil & Why Does Form Matter?

Borage Oil is classified under OMEGA FATTY ACIDS and has been investigated across 32 peer-reviewed PubMed publications for its role in cell membrane phospholipid integrity, triglyceride modulation, and eicosanoid resolution.

In clinical nutrition, physiological efficacy depends heavily on the specific chemical salt, chelate, or standardized extract used, as well as adherence to trial-validated dosing (880 mg, 540 mg, 4.63 mg).

02

Who Benefits Most & Common Depletion Factors

Suboptimal status or increased physiological demand for Borage Oil frequently arises from restrictive dietary patterns, age-related declines in gastrointestinal absorption, chronic metabolic stress, or medication-induced nutrient depletion.

Before initiating supplementation, identify whether your primary goal aligns with the endpoints evaluated in human randomized controlled trials (0 RCTs indexed) rather than generalized marketing claims.

03

Physiological Mechanism of Action

Within human physiology, Borage Oil acts on pathways governing cell membrane phospholipid integrity, triglyceride modulation, and eicosanoid resolution. Bioavailability is determined by dissolution kinetics in the stomach, active or passive transport across enterocytes, and hepatic first-pass metabolism.

Choose IFOS/heavy-metal-tested small-pelagic fish or algal oil in individual blister packs to prevent lipid peroxidation.

04

PubMed Clinical Evidence & GRADE Evaluation

NICEVIVA assigns Borage Oil an overall evidence rating of GRADE High (4.0 / 4.0) based on 32 PubMed studies: 2 meta-analyses, 2 systematic reviews, and 0 randomized controlled trials (2 double-blind, n = 7,744 total participants).

Representative peer-reviewed findings include: • PMID:22336810 (2012) — "Dietary supplements for established atopic eczema." (A convincingly positive result from a much larger st) • PMID:34606560 (2021) — "Borage oil intake by overweight young adults: no effect on metabolic rate; beneficial effects on plasma triglyceride and HDL cholesterol readings." (Some research has raised the possibility that gamma linolenic acid (GLA) can increase resting metabolic rate (RMR), which can help with weight control.) • PMID:25842329 (2015) — "Singlet oxygen autoxidation of vegetable oils: evidences for lack of synergy between β-carotene and tocopherols." (The protective effect of unsaturated fatty acids was significantly better in the case of β-carotene compared to the tocopherols.)

Quantitative Clinical Effect-Size Distribution (Forest Plot)

Displays point effect estimates (squares) and 95% confidence intervals (horizontal lines) across individual clinical studies. Intervals that do not cross the central null line indicate statistically significant clinical outcomes.

Study (PMID · Year)RR Effect Size & 95% CI DistributionEstimate (95% CI)PMID 302576931.47 (7.12–10.9)PMID 213282574.240.2Null (1)5Metric: RR
05

Formulation Selection, Dosing & Chronobiology

Recommended Formulation: Purified Small-Fish rTG or Triglyceride-Form EPA/DHA. Choose IFOS/heavy-metal-tested small-pelagic fish or algal oil in individual blister packs to prevent lipid peroxidation.

Clinical Trial Dosing & Timing: Published studies most commonly utilize 880 mg · 540 mg · 4.63 mg · 2.01 g over 6 weeks · 8 weeks · 34 weeks · 36 weeks. Optimal timing window: PM 19:00 · Immediately After a Fat-Containing Meal (Bile acid and pancreatic lipase secretion during meals increases omega-3 fatty acid micellar absorption by up to 3-fold.).

06

Body Response Monitoring & Dose Adjustment

Expected Positive Response: Absence of fishy reflux and gradual improvement in lipid profile or ocular surface comfort.

Adjustment & Discontinuation Signals: Discontinue and consult a physician if easy bruising, epistaxis, or gingival bleeding occurs—especially if taking antiplatelets.

07

Prescription Drug Interactions & Contraindications

No major high-risk prescription contraindications are flagged in the primary index for Borage Oil, but divalent minerals, fat-soluble compounds, and botanical extracts can still alter absorption or CYP450 metabolism of concurrent medications.

Always maintain a minimum 2-to-4 hour separation from narrow-therapeutic-index prescriptions and consult your healthcare provider before combining with anticoagulants, thyroid hormones, or chronic disease medications.

08

4 Essential Safety Rules Before & After Dosing

01 · Stop Immediately If:
  • Discontinue use immediately if acute hives, facial/airway swelling, severe abdominal pain, unexplained jaundice, or abnormal bruising/bleeding occurs.
  • Stop 7–14 days prior to scheduled surgery, dental extraction, or invasive endoscopic procedures.
02 · Best Practices for Bioavailability:
  • Follow the optimal chronobiology window (PM 19:00 · Immediately After a Fat-Containing Meal) with a full glass of water.
  • Stay within clinically studied daily dosages (880 mg · 540 mg · 4.63 mg) and re-evaluate efficacy after 6 weeks.
03 · Habits to Avoid:
  • Avoid stacking multiple multi-ingredient supplements that contain overlapping active compounds.
  • Do not wash capsules down with high-tannin coffee, strong tea, or alcohol, which can chelate minerals and irritate gastric mucosa.
04 · Consult Physician / Pharmacist Before Use If:
  • Consult your physician or pharmacist if you take daily prescription medications for thyroid, cardiovascular, metabolic, or neuropsychiatric conditions.
  • Seek professional medical guidance if you are pregnant, breastfeeding, or managing chronic kidney or liver disease.
09 · PUBMED CLINICAL STUDIES

Indexed PubMed Clinical Studies & Abstracts (32 Studies) · 9 Quantitative Analyses

01
CLINICAL STUDY The Cochrane database of systematic reviews (2012) PMID: 22336810 ↗
Dietary supplements for established atopic eczema.
Clinical Trial Synthesis 2012 Randomized Controlled Trial (RCT) published in The Cochrane database of systematic reviews involving n = 596 participants. Key conclusion: A convincingly positive result from a much larger st
View Original PubMed Abstract ↓

BACKGROUND: Many people with atopic eczema are reluctant to use the most commonly recommended treatments because they fear the long-term health effects. As a result, many turn to dietary supplements as a possible treatment approach, often with the belief that some essential ingredient is 'missing' in their diet. Various supplements have been proposed, but it is unclear whether any of these interventions are effective. OBJECTIVES: To evaluate dietary supplements for treating established atopic eczema/dermatitis.Evening primrose oil, borage oil, and probiotics are covered in other Cochrane reviews. SEARCH METHODS: We searched the following databases up to July 2010: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE (from 2005), EMBASE (from 2007), PsycINFO (from 1806), AMED (from 1985), LILACS (from 1982), ISI Web of Science, GREAT (Global Resource of EczemA Trials) database, and reference lists of articles. We searched ongoing trials registers up to April 2011. SELECTION CRITERIA: Randomised controlled trials (RCTs) of dietary supplements for the treatment of those with established atopic eczema/dermatitis. DATA COLLECTION AND ANALYSIS: Two authors independently screened the titles and abstracts, read the full text of the publications, extracted data, and assessed the risk of bias. MAIN RESULTS: We included 11 studies with a total of 596 participants. Two studies assessed fish oil versus olive oil or corn oil placebo. The following were all looked at in single studies: oral zinc sulphate compared to placebo, selenium versus selenium plus vitamin E versus placebo, vitamin D versus placebo, vitamin D versus vitamin E versus vitamins D plus vitamin E together versus placebo, pyridoxine versus placebo, sea buckthorn seed oil versus sea buckthorn pulp oil versus placebo, hempseed oil versus placebo, sunflower oil (linoleic acid) versus fish oil versus placebo, and DHA versus control (saturated fatty acids of the same energy value). Two small studies on fish oil suggest a possible modest benefit, but many outcomes were explored. A convincingly positive result from a much larger st

02
CLINICAL STUDY Food & function (2021) PMID: 34606560 ↗
Borage oil intake by overweight young adults: no effect on metabolic rate; beneficial effects on plasma triglyceride and HDL cholesterol readings.
Clinical Trial Synthesis 2021 Clinical Study published in Food & function. Key conclusion: Some research has raised the possibility that gamma linolenic acid (GLA) can increase resting metabolic rate (RMR), which can help with weight control.
View Original PubMed Abstract ↓

Some research has raised the possibility that gamma linolenic acid (GLA) can increase resting metabolic rate (RMR), which can help with weight control. However, in overweight young adults with a family history of obesity, no effect on RMR was seen after a 6 weeks treatment with borage oil (880 mg GLA per day) or evening primrose oil (540 mg GLA per day). On the other hand, borage oil did lower plasma triglyceride readings and raise HDL cholesterol readings (mean starting values in normal range for triglycerides, borderline low for HDL). No effect was seen for body mass index, plasma total cholesterol, LDL cholesterol, or glucose. Thus, in the type of subjects studied here, borage oil, a source of GLA, did not show promise as a weight control aid, but could help prevent undesirable readings for two blood lipid measures.

03
CLINICAL STUDY Food chemistry (2015) PMID: 25842329 ↗
Singlet oxygen autoxidation of vegetable oils: evidences for lack of synergy between β-carotene and tocopherols.
Clinical Trial Synthesis 2015 Clinical Study published in Food chemistry. Key conclusion: The protective effect of unsaturated fatty acids was significantly better in the case of β-carotene compared to the tocopherols.
View Original PubMed Abstract ↓

The synergy between β-carotene and tocopherols--antioxidants protecting oils from oxidation, was analyzed in a model system. The model used stripped borage and evening primrose oils. A chlorophyll extract, β-carotene and one of the tocopherols were added together or separately to the oils. Oil oxidation was initiated by singlet oxygen that was produced by chlorophylls irradiated with the use of a xenon lamp equipped with the cut-off 600 nm filter. Experiments were carried out at two mole ratios of tocopherols to β-carotene, i.e. at 1:1 and 23:1. Analyses were performed using absorption and fluorescence spectra in the UV+Vis region. The results demonstrated an antagonistic action of the antioxidants. The protective effect of unsaturated fatty acids was significantly better in the case of β-carotene compared to the tocopherols. Furthermore, tocopherols were less effective in protecting the oils in the presence of β-carotene than without it.

04
CLINICAL STUDY International immunopharmacology (2001) PMID: 11710548 ↗
Borage oil reduction of rheumatoid arthritis activity may be mediated by increased cAMP that suppresses tumor necrosis factor-alpha.
Clinical Trial Synthesis 2001 Clinical Study published in International immunopharmacology. Key conclusion: In this paper, evidence from published research is reviewed that indicates gamma linolenic acid component of borage oil increases prostaglandin E levels that increase cAMP levels that in turn suppress tumor necrosis factor-alpha synthesis.
View Original PubMed Abstract ↓

Recent double blind studies have shown some benefit of borage oil in treatment of rheumatoid arthritis. Tumor necrosis factor-alpha has been shown to be a central mediator of inflammatory and joint destructive processes in rheumatoid arthritis. In this paper, evidence from published research is reviewed that indicates gamma linolenic acid component of borage oil increases prostaglandin E levels that increase cAMP levels that in turn suppress tumor necrosis factor-alpha synthesis. If this biochemical path of borage oil is correct then (1) concomitant non-steroidal anti-inflammatory drug use would tend to undermine borage oil effects, and (2) borage oil would be contraindicated in pregnancy given the teratogenic and labor inducing effects of prostaglandin E agonists.

05
CLINICAL STUDY Lipids (2020) PMID: 33128473 ↗
Borage Oil Treated with Immobilized Lipase Inhibits Melanogenesis.
Clinical Trial Synthesis 2020 Randomized Controlled Trial (RCT) published in Lipids; statistical significance reported at p = 0.05. Key conclusion: The analysis of the skin brightness using Chromameter CR-400 confirmed that the brightness of the treated area was significantly increased (p < 0.01) after 4, 6, and 8 weeks.
View Original PubMed Abstract ↓

In the present study, we demonstrated that borage (Borago officinalis L.) seed oil subjected to immobilized lipase pretreatment are enriched with linoleic acid (LNA, 18:2n-6), γ-linolenic acid (GLA, 18:3n-6), and oleic acid (OLA, 18:1n-9). We further showed that lipase-treated borage oil (LT-BOL) regulates the activity and degradation of tyrosinase, an important enzyme implicated in the synthesis of melanin in murine melanocytes, B16F10. LT-BOL and its free fatty acid components reduced the levels of melanin and tyrosinase in melanocytes with GLA exerting similar or stronger effects compared with LNA and OLA. The brightening efficacy of LT-BOL on melanin metabolism in humans was tested by an 8-week, double-blind, randomized clinical trial, which enrolled 21 Korean female adults (mean age 48.57 ± 3.28). Visual evaluation showed that cream containing 1% LT-BOL significantly decreased (p < 0.05) melasma on the treated skin area after 6 and 8 weeks. The analysis of the skin brightness using Chromameter CR-400 confirmed that the brightness of the treated area was significantly increased (p < 0.01) after 4, 6, and 8 weeks. Together, our results suggest that LT-BOL may be suitable as a natural skin whitening cosmeceutical product. © 2020 AOCS.

06
CLINICAL STUDY The Cochrane database of systematic reviews (2019) PMID: 31158920 ↗
Lipid emulsions for parenterally fed term and late preterm infants.
Clinical Trial Synthesis 2019 Randomized Controlled Trial (RCT) published in The Cochrane database of systematic reviews involving n = 273 participants. Key conclusion: fish oil LE versus another fish oil L
View Original PubMed Abstract ↓

BACKGROUND: Lipid emulsions (LE) form a vital component of infant nutrition for critically ill, late preterm or term infants, particularly for those with gastrointestinal failure. Conventionally used soybean oil-based LE (S-LE) have high polyunsaturated fatty acid (PUFA) content and phytosterols, which may contribute to adverse effects including parenteral nutrition-associated liver disease (PNALD). OBJECTIVES: To compare the safety and efficacy of all LE for parenteral nutrition (PN) in term and late preterm infants (between 34 weeks' gestation and 36 weeks' and six days' gestation) with or without surgical conditions or PNALD within first six months of life, using all possible direct comparisons. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 5), MEDLINE (1946 to 18 June 2018), Embase (1974 to 18 June 2018), CINAHL (1982 to 18 June 2018), MIDRIS (1971 to 31 May 2018), conference proceedings, trial registries (ClinicalTrials.gov and the WHO's Trials Registry), and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: Randomised or quasi-randomised controlled studies in term and late preterm infants, with or without surgical conditions or PNALD. DATA COLLECTION AND ANALYSIS: Data collection and analysis conformed to the methods of Cochrane Neonatal. We used the GRADE approach to assess the quality of evidence for important outcomes in addition to reporting the conventional statistical significance of results. MAIN RESULTS: The review included nine randomised studies (n = 273). LE were classified in three broad groups: 1. all fish oil-containing LE including pure fish oil (F-LE) and multisource LE (e.g. medium-chain triglycerides (MCT)-olive-fish-soybean oil-LE (MOFS-LE), MCT-fish-soy oil-LE (MFS-LE) and olive-fish-soy-LE (OFS-LE)); 2. conventional pure S-LE; 3. alternative-LE (e.g. MCT-soy-LE (MS-LE), olive-soy-LE (OS-LE) and borage oil-based LE).We considered four broad comparisons: 1. all fish oil LE versus non-fish oil LE (6 studies; n = 182); 2. fish oil LE versus another fish oil L

07
CLINICAL STUDY The Cochrane database of systematic reviews (2019) PMID: 31158919 ↗
Lipid emulsions for parenterally fed preterm infants.
Clinical Trial Synthesis 2019 Randomized Controlled Trial (RCT) published in The Cochrane database of systematic reviews involving n = 2,037 participants. Key conclusion: MCT-soybean oil-LE (MS-LE), olive-soybean oil-LE and borage oil-based LE).We considered the following broad comparisons: fish oil LE versus non-fish oil LE; fish oil LE versus another fish oil LE; alternative-LE versus S-LE; alternative-LE versus another alternative-LE in preterm
View Original PubMed Abstract ↓

BACKGROUND: Conventionally used soybean oil-based lipid emulsion (S-LE) have high polyunsaturated fatty acid (PUFA) content and phytosterols that may contribute to adverse effects in preterm infants. The newer lipid emulsions (LE) from different lipid sources are currently available for use in preterm infants. OBJECTIVES: To compare the safety and efficacy of all LE for parenteral nutrition (PN) in preterm infants (less than 37 weeks' gestation) including preterm infants with surgical conditions or parenteral nutrition-associated liver disease (PNALD)/cholestasis using direct comparisons and pair-wise meta-analyses. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 5), MEDLINE (1946 to 18 June 2018), Embase (1974 to 18 July 2018), CINAHL (1982 to 18 June 2018), MIDRIS (1971 to 31 May 2018), conference proceedings, trial registries (ClinicalTrials.gov and WHO's Trials Registry and Platform), and reference lists of retrieved articles. SELECTION CRITERIA: Randomised or quasi-randomised controlled studies in preterm infants with or without surgical conditions or PNALD within the first six months of life. DATA COLLECTION AND ANALYSIS: Data collection and analysis conformed to the methods of Cochrane Neonatal. We used the GRADE approach to assess the quality of evidence for important outcomes in addition to reporting statistical significance of results. MAIN RESULTS: We included 29 studies (n = 2037) in this review. LE were classified in three broad groups: 1. all fish oil-containing LE including pure fish oil-LE (F-LE) and multisource LE (e.g. medium-chain triglycerides (MCT)-olive-fish-soybean oil-LE (MOFS-LE), MCT-fish-soybean oil-LE (MFS-LE) and olive-fish-soybean oil-LE (OFS-LE); 2. conventional S-LE; 3. alternative-LE (e.g. MCT-soybean oil-LE (MS-LE), olive-soybean oil-LE and borage oil-based LE).We considered the following broad comparisons: fish oil LE versus non-fish oil LE; fish oil LE versus another fish oil LE; alternative-LE versus S-LE; alternative-LE versus another alternative-LE in preterm infants less than 37 weeks' gestation, preterm infants with

08
META-ANALYSIS BMC complementary and alternative medicine (2018) PMID: 30257693 ↗
Complementary and alternative medicine for treatment of atopic eczema in children under 14 years old: a systematic review and meta-analysis of randomized controlled trials.
Clinical Trial Synthesis 2018 Meta-Analysis published in BMC complementary and alternative medicine involving n = 2,233 participants (RR 1.47). Key conclusion: CONCLUSIONS: Low evidence demonstrates that some CAM modalities may improve symptoms of childhood AE and reduce relapse rate.
View Original PubMed Abstract ↓

BACKGROUND: Due to limitations of conventional medicine for atopic eczema (AE), complementary and alternative medicine (CAM) is widely used as an alternative, maintaining, or simultaneous treatment for AE. We aimed to evaluate the beneficial and harmful effects of CAM for children with AE under 14 years old. METHODS: We searched for randomized trials on CAM in 12 Chinese and English databases from their inception to May 2018. We included children (< 14 years) diagnosed with AE, who received CAM therapy alone or combined with conventional medicine. We extracted data, and used the Cochrane "Risk of bias" tool to assess methodological quality. Effect was presented as relative risk (RR) or mean difference (MD) with 95% confidence interval (CI) using RevMan 5.3. RESULTS: Twenty-four randomized controlled trials involving 2233 children with AE were included. Methodological quality was of unclear or high risk of bias in general. The trials tested 5 different types of CAM therapies, including probiotics, diet, biofilm, borage oil, and swimming. Compared to placebo, probiotics showed improved effect for the SCORAD index (MD 9.01, 95% CI 7.12-10.90; n = 5). For symptoms and signs such as itching, skin lesions, CAM combined with usual care was more effective for symptom relief ≥95% (RR 1.47, 95% CI 1.30-1.68; n = 8), and for ≥50% symptoms improvement (RR 1.34, 1.25-1.45; n = 9) compared to usual care. There was no statistic significant difference between CAM and usual care on ≥95% improvement or ≥ 50% improvement of symptoms. However, swimming, diet and biofilm showed improvement of clinical symptoms compared with usual care. At follow-up of 8 weeks to 3 years, CAM alone or combined with usual care showed lower relapse rate (RR 0.38, 0.28-0.51, n = 2; RR 0.31, 0.24-0.40, n = 7; respectively) compared to usual care. Twelve out of 24 trials reported no occurrence of severe adverse events. CONCLUSIONS: Low evidence demonstrates that some CAM modalities may improve symptoms of childhood AE and reduce relapse rate. Safety remains unclear due to insufficient reporting. Further well-designed randomized trials are needed to confirm the potential beneficial effect and to establish

09
CLINICAL STUDY The Cochrane database of systematic reviews (2015) PMID: 26630252 ↗
Alternative lipid emulsions versus pure soy oil based lipid emulsions for parenterally fed preterm infants.
Clinical Trial Synthesis 2015 Randomized Controlled Trial (RCT) published in The Cochrane database of systematic reviews involving n = 979 participants. Key conclusion: The newer lipid emulsions (LE) from alternative lipid sources with reduced PUFA content may improve clinical outcomes in preterm infants.
View Original PubMed Abstract ↓

BACKGROUND: The pure soybean oil based lipid emulsions (S-LE) conventionally used for parenteral nutrition (PN) in preterm infants have high polyunsaturated fatty acid (PUFA) content. The newer lipid emulsions (LE) from alternative lipid sources with reduced PUFA content may improve clinical outcomes in preterm infants. OBJECTIVES: To determine the safety and efficacy of the newer alternative LE compared with the conventional S-LE for PN in preterm infants. SEARCH METHODS: We used the standard search strategy of the Cochrane Neonatal Review Group (CNRG) to search the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 7), MEDLINE (1946 to 31 July 2015), EMBASE (1947 to 31 July 2015), CINAHL (1982 to 31 July 2015), Web of Science (31 July 2015), conference proceedings, trial registries (clinicaltrials.gov, controlled-trials.com, WHO's ICTRP), and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials in preterm infants (< 37 weeks), comparing newer alternative LE with S-LE. DATA COLLECTION AND ANALYSIS: Data collection and analysis conformed to the methods of the CNRG. We assessed the quality of evidence for important outcomes using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, in addition to reporting the conventional statistical significance of results. MAIN RESULTS: Fifteen studies (N = 979 infants) are included in this review. Alternative LE including medium chain triglycerides/long chain triglycerides (MCT/LCT) LE (3 studies; n = 108), MCT-olive-fish-soy oil-LE (MOFS-LE; 7 studies; n = 469), MCT-fish-soy oil-LE (MFS-LE; 1 study; n = 60), olive-soy oil-LE (OS-LE; 7 studies; n = 406), and borage-soy oil-LE (BS-LE; 1 study; n = 34) were compared with S-LE. The different LE were also considered together to compare 'all fish oil containing-LE' versus S-LE (7 studies; n = 499) and 'all alternative LE' versus S-LE (15 studies; n = 979). Some studies had multiple intervention arms and were included in more than one comparison. No study compared pure fish oil-LE or structured-LE to S-LE.The GRADE qu

10
SYSTEMATIC REVIEW Clinical and experimental dermatology (2015) PMID: 25622761 ↗
What's new in atopic eczema? An analysis of systematic reviews published in 2012 and 2013. Part 2. Treatment and prevention.
Clinical Trial Synthesis 2015 Systematic Review published in Clinical and experimental dermatology. Key conclusion: © 2015 British Association of Dermatologists.
View Original PubMed Abstract ↓

This review provides a summary of key findings from 22 systematic reviews on atopic eczema (AE) published over the 2-year period from January 2012 to 31 December 2013, focusing on prevention and treatment of AE. For an update of systematic reviews on the epidemiology, mechanisms of disease and methodological issues, see Part 1 of this update. Based on current systematic review evidence, the most promising intervention for the prevention of AE is the use of probiotics (and possibly prebiotics) during the late stages of pregnancy and early life. Exposure to household pets, especially dogs, may also be protective, but exclusive breastfeeding for up to 7 months does not confer benefit. The role of vitamin D in preventing AE is currently unclear. Very few of the systematic reviews provided additional evidence for the use of specific treatments for AE. Further research is required to establish the role of desensitization, Chinese herbal medicines, homeopathy and specialist clothing. Nevertheless, there is now clear evidence that evening primrose oil and borage oil are not effective for the treatment of AE. There have been no randomized controlled trials on the use of H1 anti-histamines as monotherapy for the treatment of AE. © 2015 British Association of Dermatologists.

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