Vitamin D supplementation and disease activity in patients with immune-mediated rheumatic diseases: A systematic review and meta-analysis
Medicine: June 2017 - Volume 96 - Issue 23 - p e7024; doi: 10.1097/MD.0000000000007024
Franco, André Silva MDa; Freitas, Thiago Quadrantea; Bernardo, Wanderley M. MD, PhDb; Pereira, Rosa Maria R. MD, PhDa,*
Most meta-analyses unfortunately ignore the dose size
In this case the dose sizes ranged from 2,000 IU daily to 50,000 weekly (7,100 daily)
They also included a Vitamin D2 study and several calcitriol studies
- Meta-analysis of Vitamin D category listing has
- Overview Rheumatoid Arthritis and vitamin D
- Every patient with rheumatoid arthritis had low vitamin D, severity was proportional to degree of deficiency – June 2014
- Active Rheumatologic disease was 5X more likely with low vitamin D – June 2013
- Rheumatoid Arthritis strongly associated with low vitamin D – meta-analysis April 2016
- 43 percent of Rheumatoid Arthritis patients have Vitamin D prescriptions (15 countries) – June 2017
- Rheumatoid arthritis is 40 percent more likely if vitamin D Receptor problem – 2 meta-analyses 2015
Background: Vitamin D serum levels and the presence and activity of rheumatic conditions have been associated. However, many studies are merely observational, and the existent randomized clinical trials were never systematically analyzed. Therefore, this study aims to provide a systematic review and meta-analysis of such a topic.
Methods: MEDLINE, EMBASE, LILACS, COCHRANE, and CINAHL were explored to identify randomized trials that investigated clinical repercussions of vitamin D (or analogs) supplementation for at least 3 months in rheumatic diseases. Standardized clinical and/or laboratorial outcomes related to disease activity were analyzed according to each disease before and after supplementation.
Results: Database searches rendered 668 results; 9 were included—5 on rheumatoid arthritis, 3 on systemic lupus erythematosus, and 1 on systemic sclerosis. Seven of the studies were meta-analyzed. After vitamin D supplementation, rheumatoid arthritis recurrence decreased; however, not significantly (risk difference = −0.10, 95% CI = −0.21, 0.00, P = .05). No statistical significance was observed regarding visual analog scale (mean difference = 2.79, 95% CI = −1.87, 7.44, P = .24) and disease activity score28 (mean difference = −0.31, 95% CI = −0.86, 0.25, P = .28). Regarding systemic lupus erythematosus, anti-dsDNA positivity was significantly reduced (risk difference = −0.10, 95% CI = −0.18, −0.03; P = .005).
Conclusion: Vitamin D supplementation reduced anti-dsDNA positivity on systemic lupus erythematosus and could possibly reduce rheumatoid arthritis recurrence, although novel randomized clinical trials are needed to confirm and extend the benefits of this hormone in immune-mediated rheumatic diseases.
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