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50,000 IU of vitamin D weekly (D3 or D2) got two thirds of cystic fibrosis patients to 30 nanograms – RCT July 2015

A randomized controlled trial of vitamin D replacement strategies in pediatric CF patients.

J Cyst Fibros. 2015 Jul 23. pii: S1569-1993(15)00166-6. doi: 10.1016/j.jcf.2015.07.004. [Epub ahead of print]
Simoneau T1, Sawicki GS2, Milliren CE3, Feldman HA3, Gordon CM4.
1Boston Children's Hospital, Division of Respiratory Diseases, Harvard Medical School, 300 Longwood Ave, Boston, MA, United States. Electronic address: tsimoneau at connecticutchildrens.org.
2Boston Children's Hospital, Division of Respiratory Diseases, Harvard Medical School, 300 Longwood Ave, Boston, MA, United States.
3Clinical Research Center, Boston Children's Hospital, Boston, MA, United States.
4Hasbro Children's Hospital, Alpert Medical School of Brown University, Providence, RI, United States.

BACKGROUND:
Vitamin D insufficiency is common in children with cystic fibrosis (CF), yet data are sparse regarding the most effective form of vitamin D supplementation. The aim of this study was to compare two different vitamin D replacement regimens.

METHODS:
We conducted a randomized controlled trial comparing 50,000IU of ergocalciferol (vitamin D2) twice weekly for 8weeks versus 50,000IU of cholecalciferol (vitamin D3) weekly in patients with CF, pancreatic insufficiency, age 6-21years and a 25(OH)D<30ng/mL. The primary outcome was change in serum 25(OH)D concentration. For secondary analyses, we examined changes in IgG, IgE and CRP in patients who normalized their vitamin D levels.

RESULTS:
A total of 47 patients completed the trial. The mean pre-treatment 25(OH)D concentration was 23.1 (SD 4.7) ng/mL. The overall mean increase in 25(OH)D was 11.1 (11.9) ng/mL and 31/47 (66%) achieved a 25(OH)D concentration≥30ng/mL; of the 26 participants who received D2, 18 (69%) achieved sufficiency while 13/21 (62%) participants treated with D3 achieved sufficiency. There was no difference between groups in change of 25(OH)D (p=0.65). Similarly, there was no difference in the number of patients to achieve vitamin D sufficiency between treatments (p=0.6).

CONCLUSIONS:
Ergocalciferol administered as 50,000IU twice weekly is as effective as cholecalciferol 50,000IU weekly for 8weeks in pediatric patients with CF and vitamin D insufficiency. Only 66% of the patients studied achieved the desired 25(OH)D concentration.

Copyright © 2015 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

PMID: 26211605


See also VitaminDWiki

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