Higher Vitamin D increased the benefit of anti-TNF- α drug used for IBD by 2.6 times

Created January 2017

Higher 25-hydroxyvitamin D levels are associated with greater odds of remission with anti-tumour necrosis factor-α medications among patients with inflammatory bowel diseases

Alimentary Pharmacology & Therapeutics, DOI: 10.1111/apt.13936

R. W. Winter, E. Collins, B. Cao, M. Carrellas, A. M. Crowell, J. R. Korzenik

"Higher" is > 33 ng of vitamin D Note: Perhaps those with higher vitamin D did not even need the anti-TNF * Inflammatory bowel diseases treated with vitamin D – Review May 2014 mentions TNF * Vitamin D and Inflammatory Bowel Disease – review April 2015 mentions TNF * Gut doctors becoming aware of importance of vitamin D – May 2012 mentions TNF Studies which are in both categories of Intervention AND Gut {category} Studies which are in both categories of Intervention AND Rheumatoid Arthritis {category} Studies which are in both categories of Intervention AND Psorasis {category} See also web * TNF Inhibitor Wikipedia * “A TNF inhibitor is a pharmaceutical drug that suppresses the physiologic response to tumor necrosis factor (TNF), which is part of the inflammatory response. TNF is involved in autoimmune and immune-mediated disorders such as rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease, psoriasis, hidradenitis suppurativa and refractory asthma .” * [Nutraingredients discussion of this study](http://www.nutraingredients.com/Research/Vitamin-D-may-boost-IBD-treatment-success-Study?utm_source=RSS_text_news&utm;_medium=RSS_feed&utm;_campaign=RSS_Text_News)

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Background

Vitamin D has been linked to disease activity among patients with inflammatory bowel diseases (IBD). Prior investigation has also suggested that vitamin D levels may affect duration of therapy with anti-tumour necrosis factor-α (anti-TNF-α) medications among patients with IBD.

Aim

To evaluate the relationship between vitamin D levels and odds of reaching remission while on an anti-TNF-α medication.

Methods

A total of 521 IBD patients enrolled in the Brigham and Women's IBD Centre database were eligible for inclusion. Patients treated with anti-TNF-α therapy who had vitamin D levels drawn within 6 months prior or 2 weeks after initiation of anti-TNF-α medication and who had reported remission status at 3 months were included. A logistic regression model adjusting for age, gender, IBD diagnosis, anti-TNF-α medication (infliximab vs. adalimumab) and first or subsequent anti-TNF-α medication was used to identify the effect of vitamin D level on initial response to anti-TNF-α therapy.

Results

A total of 173 patients were included in the final analysis. On logistic regression, patients with normal vitamin D levels n = 122 at the time of anti-TNF-α medication initiation had a 2.64 increased odds of remission at 3 months compared to patients with low vitamin D levels n = 51 when controlling for age, gender, diagnosis, type of anti-TNF-α medication and first or subsequent anti-TNF-α medication (OR = 2.64, 95% CI = 1.31–5.32, P = 0.0067).

Conclusions

These findings suggest that vitamin D levels may influence initial response to anti-TNF-α medication and that low vitamin D levels may pre-dispose patients to decreased odds of remission.

Tags: Gut