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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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 Download the PDF from SciHub via VitaminDWiki
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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 17:24 63.26 Kb 99
11211 COPD 2019 Sci-Hub.pdf PDF 2019 admin 15 Jan, 2019 17:23 618.21 Kb 147
11210 COPD figure.jpg admin 15 Jan, 2019 17:16 27.87 Kb 113
11209 COPD myths.jpg admin 15 Jan, 2019 17:05 119.38 Kb 108
11208 Lungs in COPD.jpg admin 15 Jan, 2019 17:04 57.99 Kb 281
11207 Prevalence low D and COPD.jpg admin 15 Jan, 2019 17:04 46.27 Kb 97
11206 Hospitalized COPD Patients.PDF admin 15 Jan, 2019 17:04 386.77 Kb 44
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