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COPD exacerbations 2X less often if low vitamin D then supplemented – meta-analysis Jan 2019

Vitamin D to prevent exacerbations of COPD: systematic review and meta-analysis of individual participant data from randomised controlled trials.

Thorax. 2019 Jan 10. pii: thoraxjnl-2018-212092. doi: 10.1136/thoraxjnl-2018-212092.
Jolliffe DA1, Greenberg L1, Hooper RL1, Mathyssen C2, Rafiq R3, de Jongh RT3, Camargo CA4, Griffiths CJ1,5, Janssens W#2, Martineau AR#1,5.

VitaminDWiki

COPD = Chronic obstructive pulmonary disease , includes chronic bronchitis and emphysema

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COPD and Genes

see wikipage http://www.vitamindwiki.com/tiki-index.php?page_id=2047

See also Web

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"Vitamin D Deficiency and Insufficiency in Hospitalized COPD Patients" 2015
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BACKGROUND:
Randomised controlled trials (RCTs) of vitamin D to prevent COPD exacerbations have yielded conflicting results.Individual participant data meta-analysis could identify factors that explain this variation.

METHODS:
PubMed, Embase, the Cochrane Central Register of Controlled Trials and Web of Science were searched from inception up to and including 5 October 2017 to identify RCTs of vitamin D supplementation in patients with COPD that reported incidence of acute exacerbations. Individual participant data meta-analysis was performed using fixed effects models adjusting for age, sex, Global Initiative for Chronic Obstructive Lung Disease spirometric grade and trial.

RESULTS:
Four eligible RCTs (total 560 participants) were identified; individual participant data were obtained for 469/472 (99.4%) participants in three RCTs. Supplementation did not influence overall rate of moderate/severe COPD exacerbations (adjusted incidence rate ratio (aIRR) 0.94, 95% CI 0.78 to 1.13). Prespecified subgroup analysis revealed that protective effects were seen in participants with baseline 25-hydroxyvitamin D levels <25 nmol/L (aIRR 0.55, 95% CI 0.36 to 0.84) but not in those with baseline 25-hydroxyvitamin D levels ≥25 nmol/L (aIRR 1.04, 95% CI 0.85 to 1.27; p for interaction=0.015). Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event (adjusted OR 1.16, 95% CI 0.76 to 1.75).

CONCLUSIONS:
Vitamin D supplementation safely and substantially reduced the rate of moderate/severe COPD exacerbations in patients with baseline 25-hydroxyvitamin D levels <25 nmol/L but not in those with higher levels.

TRIAL REGISTRATION NUMBER: CRD42014013953.

Continuing Medical Education for this study, with credit


Created by admin. Last Modification: Sunday October 6, 2019 23:22:24 GMT-0000 by admin. (Version 12)

Attached files

ID Name Comment Uploaded Size Downloads
11212 Table 1 COPD.jpg admin 15 Jan, 2019 63.26 Kb 661
11211 COPD 2019 Sci-Hub.pdf admin 15 Jan, 2019 618.21 Kb 1608
11210 COPD figure.jpg admin 15 Jan, 2019 27.87 Kb 703
11209 COPD myths.jpg admin 15 Jan, 2019 119.38 Kb 833
11208 Lungs in COPD.jpg admin 15 Jan, 2019 57.99 Kb 1225
11207 Prevalence low D and COPD.jpg admin 15 Jan, 2019 46.27 Kb 763
11206 Hospitalized COPD Patients.PDF admin 15 Jan, 2019 386.77 Kb 557