High doses of vitamin D to reduce exacerbations in chronic obstructive pulmonary disease: a randomized trial.
Ann Intern Med. 2012 Jan 17;156(2):105-14.
Lehouck A, Mathieu C, Carremans C, Baeke F, Verhaegen J, Van Eldere J, Decallonne B, Bouillon R, Decramer M, Janssens W.
University Hospitals Leuven, Belgium.
Low serum 25-hydroxyvitamin D (25-[OH]D) levels have been associated with lower FEV(1), impaired immunologic control, and increased airway inflammation. Because many patients with chronic obstructive pulmonary disease (COPD) have vitamin D deficiency, effects of vitamin D supplementation may extend beyond preventing osteoporosis.
OBJECTIVE: To explore whether supplementation with high doses of vitamin D could reduce the incidence of COPD exacerbations.
DESIGN: Randomized, single-center, double-blind, placebo-controlled trial. (ClinicalTrials.gov registration number: NCT00666367)
SETTING: University Hospitals Leuven, Leuven, Belgium.
PATIENTS: 182 patients with moderate to very severe COPD and a history of recent exacerbations.
INTERVENTION: 100,000 IU of vitamin D supplementation or placebo every 4 weeks for 1 year.
MEASUREMENTS: The primary outcome was time to first exacerbation. Secondary outcomes were exacerbation rate, time to first hospitalization, time to second exacerbation, FEV(1), quality of life, and death.
RESULTS: Mean serum 25-(OH)D levels increased significantly in the vitamin D group compared with the placebo group (mean between-group difference, 30 ng/mL [95% CI, 27 to 33 ng/mL]; P < 0.001). The median time to first exacerbation did not significantly differ between the groups (hazard ratio, 1.1 [CI, 0.82 to 1.56]; P = 0.41), nor did exacerbation rates, FEV(1), hospitalization, quality of life, and death.
However, a post hoc analysis in 30 participants with severe vitamin D deficiency (serum 25-[OH]D levels <10 ng/mL) at baseline showed a significant reduction in exacerbations in the vitamin D group (rate ratio, 0.57 [CI, 0.33 to 0.98]; P = 0.042).
This was a single-center study with a small sample size.
High-dose vitamin D supplementation in a sample of patients with COPD did not reduce the incidence of exacerbations. In participants with severe vitamin D deficiency at baseline, supplementation may reduce exacerbations.
PRIMARY FUNDING SOURCE:
Applied Biomedical Research Program, Agency for Innovation by Science and Technology (IWT-TBM).
Severe vitamin D deficiency: a prerequisite for COPD responsiveness to vitamin D supplementation? [Ann Intern Med. 2012]
Summary for patients in
Ann Intern Med. 2012 Jan 17;156(2):I26.
PDF is attached at the bottom of this page
Another study in 2013 did not find statistically significant improvement after raising vitamin D levels from 20 to 30 ng
Int J Chron Obstruct Pulmon Dis. 2013;8:97-104. doi: 10.2147/COPD.S40885. Epub 2013 Feb 15.
Bjerk SM, Edgington BD, Rector TS, Kunisaki KM.
University of Minnesota, Minneapolis, MN, USA.
BACKGROUND: Low 25-hydroxyvitamin D (25[OH]D) levels, commonly observed in chronic obstructive pulmonary disease (COPD), are associated with muscle weakness in elderly populations, and vitamin D supplementation appears to improve muscle strength and decrease falls in older individuals. We tested the effect of vitamin D supplementation on physical performance in patients with COPD.
METHODS: Patients were randomized to daily cholecalciferol (2000 IU) or placebo for 6 weeks.
The primary outcome was the 6-week change in Short Physical Performance Battery (SPPB) score.
Secondary outcomes included changes in the St George's Respiratory Questionnaire (SGRQ) score, and serum 25(OH)D.
RESULTS: Thirty-six participants (mean age 68 years, all Caucasian males, mean forced expiratory volume in one second 33% of predicted) completed the study.
Despite an increase in 25(OH)D levels in the intervention arm to a mean of 32.6 ng/mL (versus 22.1 ng/mL in the placebo arm), there was no difference in improvements in either SPPB scores (0.3 point difference; 95% confidence interval -0.8 to 1.5; P = 0.56) or SGRQ scores (2.3 point difference; 95% confidence interval -2.3 to 6.9; P = 0.32).
CONCLUSION: Among patients with severe COPD, 2000 IU of daily vitamin D for 6 weeks increased 25(OH)D to a level widely considered as normal.
However, compared with placebo, short-term vitamin D supplementation had no discernible effect on a simple measure of physical performance.
PDF is attached at the bottom of this page
Interesting how they totally hide the information about vitamin D helping COPD pateints with severly low vitamin D
The attached paper does not even appear to mention the % of patients in that category (< 10ng)
- Respiratory infections reduced by 63 percent with 4000 IU vitamin D daily - RCT Dec 2012
- COPD and vitamin D in a vicious circle – April 2011
- 100000 IU vitamin D monthly helped COPD patients – 2011 and 2012
- Less COPD if vitamin D more than 30 ng – Nov 2011