Role of Vitamin D in Infliximab-induced Remission in Adult Patients with Crohn's Disease.
Inflamm Bowel Dis. 2015 Sep 9. [Epub ahead of print]
Reich KM1, Fedorak RN, Madsen K, Kroeker KI.7
1Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada.
All patients treated with infliximab
Vitamin D injections for those with vitamin D deficiency
Dose size not stated in abstract
|After 14 weeks||Low D and Injection||OK D, No injection|
|Significant reduction in Crohn’s Disease||80%||23%|
Note that infliximab is also used for
- rheumatoid arthritis,
- arthritis of the spine,
- psoriatic arthritis
- ulcerative colitis
- chronic plaque psoriasis
See also VitaminDWiki
Gut and Vitamin D Intervention studies on VitaminDWiki
- IBS not helped by daily 3,000 IU Vitamin D (but non-daily and gut-friendly help) – RCT July 2021
- Diverticular disease:12X reduction if low Vitamin D and given 100,000 IU monthly – RCT Aug 2020
- Irritable Bowel Syndrome treated by weekly 50,000 IU Vitamin D – RCT Feb 2019
- Ulcerative Colitis inflammation treated by weekly vitamin D (40,000 IU) – July 2018
- Gut bacteria of Crohn's disease patients improved by Vitamin D – March 2018
- Vitamin D changed microbiota in gut and airway, might reduce cystic fibrosis – RCT Nov 2017
- Crohn's Disease relapse rate of 3 in 8 with 1,000 IU vs 0 in 12 with 10,000 IU of Vitamin D – RCT Feb 2017
- Ulcerative colitis treated by injection of 300,000 IU of vitamin D – RCT July 2016
- IBS quality of life improved by vitamin D (50,000 IU every two weeks) – RCT May 2016
- IBS – 82 percent had low vitamin D, 3,000 IU spray helped a lot – RCT Dec 2015
- Crohn's disease treated by 2000 IU Vitamin D - RCT June 2015
- Crohn’s disease helped when vitamin D level raised above 30 ng – RCT Feb 2015
- Crohn's Disease patients normalizing their Vitamin D levels decreased risk of surgery by 44 percent – Aug 2013
- Crohn’s helped by 5000 IU vitamin D – April 2013
Vitamin D is a key immunomodulator and its deficiency is prevalent among Crohn's patients. The interaction between vitamin D and the response to infliximab induction therapy has not been previously described.
Patients with moderate-severe Crohn's disease, defined as having a modified Harvey Bradshaw index ≥8, who were being induced with infliximab were recruited. Patients were divided into low and normal vitamin D groups. Patients were followed prospectively for 14 weeks for achievement of clinical remission (Harvey Bradshaw index <5). At week 14, vitamin D deficient patients were supplemented with intramuscular cholecalciferol; all patients were re-assessed at week 22. Serum cytokine levels were measured at weeks 0, 14, and 22.
Twenty-eight patients initiating infliximab were included, with 54% of patients in the low vitamin D group. The proportion of patients in clinical remission was greater in the low vitamin D group compared with the normal vitamin D group at both
- week 14 (80% versus 23%, P = 0.007) and
- week 22 (79% versus 17%, P = 0.005).
The low vitamin D group had higher baseline IL-6 levels (median, 4.4 [interquartile range, 2.0-5.7] versus 1.1 [0.8-1.7] pg/mL, P = 0.004) and lower interleukin-12 levels (0.3 [0.1-0.4] versus 0.5 [0.5-0.6] pg/mL, P = 0.006) compared with the normal vitamin D group. At week 14, IL-8 levels were significantly lower in the low vitamin D group compared with the normal vitamin D group (11.2 [9.1-13.8] versus 20.5 [17.9-37.2] pg/mL, P = 0.005).
Crohn's patients initiating infliximab with a low vitamin D level are more likely to achieve infliximab-induced clinical remission at week 14.