09/04/2026
Los pacientes con artritis reumatoide (AR) que recibieron suplementación regular con triglicéridos de cadena media (TCM) mostraron mejoras notables en su calidad de vida relacionada con la salud.
Este fue un análisis de seguimiento del ensayo aleatorizado MIKARA (Cetosis inducida por TCM y fibra en la artritis reumatoide), unicéntrico y doble ciego, de 16 semanas de duración, que examinó los resultados secundarios en pacientes con AR que recibían tratamiento farmacológico estable y una formulación nutricional dos veces al día. La formulación contenía 30 g/día de TCM o una formulación idéntica con triglicéridos de cadena larga (no se especificó el contenido de ácidos grasos para el grupo activo ni para el grupo control). A las 8 semanas, se añadieron 30 g/día de fibra de bambú a ambos grupos para explorar posibles efectos sobre la microbiota y mejorar la tolerabilidad. En los 56 pacientes que completaron el estudio, el grupo de TCM mostró mejoras significativamente mayores que el grupo control en varios resultados informados por los pacientes, incluyendo fatiga, vitalidad y salud mental, intensidad del dolor y duración y gravedad de la rigidez matutina, con tamaños del efecto de moderados a grandes. Los marcadores objetivos, como los perfiles lipídicos, mostraron pocos cambios. Es importante destacar que la mayor parte de la mejoría se produjo durante las primeras 8 semanas, antes de la introducción de la fibra, lo que sugiere que cualquier beneficio se relacionó principalmente con los triglicéridos de cadena media (TCM).
Sin embargo, dado que los resultados del ensayo fueron en gran medida subjetivos, el tamaño de la muestra fue pequeño y el comparador fue otra grasa en lugar de un placebo inerte, estos resultados respaldan un posible efecto coadyuvante sintomático más que una clara actividad modificadora de la enfermedad.
«Nuestra evidencia actual sugiere que los TCM tienen el potencial de mejorar la función cognitiva y el bienestar general en estos pacientes. Por lo tanto, proponemos que los TCM podrían servir como una intervención dietética complementaria prometedora», escribieron los autores del estudio.
Patients with rheumatoid arthritis (RA) who received regular medium-chain triglyceride (MCT) supplementation showed notable improvements in their health-related quality of life.
This was a follow-up analysis of the 16-week, single-centre, double blind MIKARA (MCT-Induced Ketosis and Fiber in Rheumatoid Arthritis) randomised trial that examined secondary outcomes in RA for patients on stable drug therapy who received a twice-daily nutritional formulation. The formulation contained either 30 g/day of MCTs or an identical formulation containing long-chain triglycerides (the fatty acid contents were not specified for active or control). At 8 weeks, 30 g/day of bamboo fibre was added to both groups to explore possible microbiome effects and improve tolerability. In the 56 completers, the MCT group showed significantly greater improvements than controls in several patient-reported outcomes, including fatigue, vitality and mental health domains, pain intensity, and duration and severity of morning stiffness, with moderate-to-large effect sizes reported. Objective markers such as lipid profiles changed little. Importantly, most of the improvement occurred during the first 8 weeks before the fibre was introduced, suggesting any benefit was mainly related to the MCT.
However, because the trial outcomes were largely subjective, the sample size was small, and the comparator was another fat rather than an inert placebo, these results support a possible symptomatic adjunct effect rather than a clear disease-modifying activity.
“Our current evidence suggests that MCTs have the potential to enhance cognitive function and overall well-being in these patients. Therefore, we propose that MCTs could serve as a promising dietary complementary intervention,” the authors of the study wrote.
The original MIKARA report described the same trial in 61 patients with low-to-moderate RA activity, with the primary endpoint being any change in the Simplified Disease Activity Index (SDAI) from baseline to week 16 during supplementation. The MCT group showed a significantly greater reduction in the SDAI than controls (mean decrease 7.2 vs 1.8), corresponding to a large effect size around 0.8, Increases in β-hydroxybutyrate levels were also seen, but there was little change in CRP or other objective inflammatory markers. Notably, a reduction in SDAI indicates improvement in actual RA signs and symptoms rather than just subjective wellbeing.
Clinically, these findings are best applied by viewing MCT supplementation (at around 20 to 30 g/day in divided doses) as a supportive metabolic intervention for RA. The improvements in fatigue, pain, stiffness and SDAI, together with increased β-hydroxybutyrate, suggest benefit from a mild nutritional ketosis and an altered energy metabolism, rather than any direct anti-inflammatory effect.
For more information see:
https://www.medscape.com/viewarticle/adding-medium-chain-triglycerides-diet-can-improve-quality-2026a1000674?ecd=wnl_tp10_daily_260228_MSCPEDIT_etid8141655&uac=48709HJ&impID=8141655
https://pubmed.ncbi.nlm.nih.gov/41698796/
https://pubmed.ncbi.nlm.nih.gov/37686750/
