Vitamin D replacement in children with acute wheeze: a dose-escalation study
ERJ Open Research 2022 8: 00609-2021; DOI: 10.1183/23120541.00609-2021
Christos Stefanidis, Andrew Bush, Christopher Newby, Chinedu Nwokoro, Susan Liebeschuetz, Imogen P. Skene, Christopher J. Griffiths, Adrian R. Martineau
Vitamin D supplementation at the current UK recommended level (400 IU·day−1) or enhanced supplementation (1000 IU·day−1) failed to achieve adequate levels of vitamin D (>75 nmol·L−1) in vitamin-D-insufficient children with acute wheeze https://bit.ly/3J43Ouo
To the Editor:
Meta-analyses report protective effects of vitamin D supplementation against asthma exacerbations and acute respiratory infections in adults [1–3], but data relating to effects of vitamin D on risk of preschool wheeze and asthma attacks in childhood are more limited [4]. In preparation for a randomised controlled trial (RCT) of vitamin D in children with recurrent preschool wheeze or school-age asthma, we carried out a dose-escalation study to find the daily vitamin D3 supplementation regimen that is most effective in elevating circulating 25-hydroxyvitamin D (25(OH)D) concentrations in these children. We hypothesised that daily oral vitamin D3 supplementation of 1000 IU would be more effective than 400 IU (UK recommendation [5]) in elevating the circulating 25(OH)D concentration to ≥75 nmol·L−1 at 3 months in vitamin-D-insufficient children with recurrent preschool wheeze or school-age asthma.
Children were recruited from primary and secondary care if they were aged 1–4 years with ≥2 self-reported episodes of acute wheeze requiring unscheduled healthcare attendances in the preceding year (preschool children), or aged 5–12 years with doctor-diagnosed asthma and ≥1 self-reported asthma attack requiring an unscheduled healthcare attendance in the preceding year (school children). Exclusion criteria were baseline 25(OH)D level ≥75 nmol·L−1, concurrent vitamin D supplementation, or a history of other chronic or acute respiratory or systemic conditions.
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Study should have increased the dose size with increased weight or age
Example: 1000 IU at 25 lbs, 3,000 IU at age 9