High-Dose Vitamin D3 during Tuberculosis Treatment in Mongolia. A Randomized Controlled Trial
American Journal of Respiratory and Critical Care Medicine https://doi.org/10.1164/rccm.201705-0936OC PubMed: 28692301
Suspect trial would have been successful it it had lasted 4 months instead of just 2
- Overview Tuberculosis and Vitamin D
- Tuberculosis 4.5X more likely if vitamin D less than 10 nanogram – meta-analysis May 2015
- TB conversion 10X less likely if have sufficient vitamin D – Dec 2011
Items in both categories TB and Intervention are listed here:
- Spinal TB surgery now includes Vitamin D as the standard of care (5,000 IU daily) – Sept 2024
- TB treatment helped by the addition of Vitamin D (100,000 IU bi-weekly) – RCT April 2024
- Tuberculosis not prevented by a tiny amount of vitamin D (equiv to 1,400 IU daily) – RCT May 2023
- Tuberculosis treatment helped a bit by a bit of Vitamin D - RCT Feb 2022
- TB not prevented by a small amount of Vitamin D (2,000 IU daily average, Mongolia) – RCT July 2020
- TB not treated by vitamin D given for only 2 months – RCT Sept 2017
- Tuberculosis recovery speeded up by single 450,000 IU dose of vitamin D – RCT Jan 2017
- Tuberculosis treatment greatly helped by injection of 200,000 IU of vitamin D – RCT April 2016
- Tuberculosis -100 percent cure rate with 10,000 IU of vitamin D daily – RCT 2006
- Tuberculosis not treated by lots of vitamin D for 16 weeks – RCT Sept 2015
- Every TB patient benefited from 2 doses of 600,000 IU of vitamin D – RCT Jan 2013
- TB treatment helped with Vitamin D – RCT Sept 2012
- Probability of getting TB reduced 60 percent with just 800 IU of vitamin D – RCT Aug 2012
- Overview Tuberculosis and Vitamin D
- Evaluating the vitamin D evidence - Heaney Dec 2010
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Davaasambuu Ganmaa , Baatar Munkhzul , Wafaie Fawzi , Donna Spiegelman , Walter C. Willett , Purev Bayasgalan , Erkhembayar Baasansuren , Burneebaatar Buyankhishig , Sereeter Oyun-Erdene , David A. Jolliffe , Theodoros Xenakis , . . .
Correspondence and requests for reprints should be addressed to Davaasambuu Ganmaa, M.D., Ph.D., The Department of Nutrition, Harvard T.H. Chan School of Public Health, Building 2, Room 211, 655 Huntington Avenue, Boston, MA 02115. E-mail: gdavaasa at hsph.harvard.edu
Rationale: Existing trials of adjunctive vitamin D in the treatment of pulmonary tuberculosis (PTB) are variously limited by small sample sizes, inadequate dosing regimens, and high baseline vitamin D status among participants. Comprehensive analyses of the effects of genetic variation in the vitamin D pathway on response to vitamin D supplementation are lacking.
Objectives: To determine the effect of high-dose vitamin D3 on response to antimicrobial therapy for PTB and to evaluate the influence of single-nucleotide polymorphisms (SNPs) in vitamin D pathway genes on response to adjunctive vitamin D3.
Methods: We conducted a clinical trial in 390 adults with PTB in Ulaanbaatar, Mongolia, who were randomized to receive four biweekly doses of 3.5 mg (140,000 IU) vitamin D3 (n = 190) or placebo (n = 200) during intensive-phase antituberculosis treatment.
Measurements and Main Results: The intervention elevated 8-week serum 25-hydroxyvitamin D concentrations (154.5 nmol/L vs. 15.2 nmol/L in active vs. placebo arms, respectively; 95% confidence interval for difference, 125.9–154.7 nmol/L; P < 0.001) but did not influence time to sputum culture conversion overall (adjusted hazard ratio, 1.09; 95% confidence interval, 0.86–1.36; P = 0.48). Adjunctive vitamin D3 accelerated sputum culture conversion in patients with one or more minor alleles for SNPs in genes encoding the vitamin D receptor (rs4334089, rs11568820) and 25-hydroxyvitamin D 1α-hydroxylase (CYP27B1: rs4646536) (adjusted hazard ratio ≥ 1.47; P for interaction ≤ 0.02).
Conclusions: Vitamin D3 did not influence time to sputum culture conversion in the study population overall. Effects of the intervention were modified by SNPs in VDR and CYP27B1.
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