Supplementation of 1,25 dihydroxy vitamin D3 in patients with treatment naive early rheumatoid arthritis: a randomised controlled trial

Kiran GOPINATH1, Debashish DANDA2, Article first published online: 17 OCT 2011
General Medicine Unit II Rheumatology & Clinical Immunology, Christian Medical College, Vellore, India.
Int J Rheum Dis. 2011 Oct;14(4):332-339. doi: 10.1111/j.1756-185X.2011.01684.x.

Aim:? 1,25 dihydroxy vitamin D3 has immunomodulatory functions in rheumatoid arthritis (RA) and is an anti-osteoporotic agent.
No studies exist to assess its pain-relieving action in RA.

Methods:? An open-labeled randomized trial comparing triple disease-modifying anti-rheumatic drug (DMARD) therapy and 500 IU 1,25 dihydroxy vitamin D3 + calcium combination versus triple DMARD and calcium alone was conducted. The primary outcome was the time to pain relief by patients’ visual analogue scale (VAS). Changes in VAS after first achievement of pain relief and after 3 months were noted. 25 hydroxy-vitamin D levels were correlated with disease activity scor (DAS-28), adjusting for sun exposure. Comparisons between the groups were done by Mann–Whitney test and independent samples test.

Results:? Patients on the vitamin D group (n = 59) had higher pain relief than the control group (n = 62) (50% vs. 30%, P = 0.006).
There was no significant difference in the time taken for initial pain relief between the two groups.
Occurrence of hypovitaminosis D in RA patients (68.1%) is comparable to published normal Indian prevalence.
There was no correlation between 25 hydroxy vitamin D levels and disease activity.

Conclusions:? Supplementation of 500 IU of 1,25 dihydroxy vitamin D3 daily to previously DMARD-naïve patients with early RA along with triple DMARD therapy results in a significantly higher pain relief at the end of 3 months. The number needed to treat for this additional pain relief was 5. The prevalence of vitamin D deficiency in the study population was 68.1%.
PMID: 22004229
- - - - - - - -

Summary

DMARD +500 IU of vitamin D reduced RA pain for 50%
DMARD only 30% reduction
So, 40% more got pain relief when vitamin D was added.

See also VitaminDWiki

• All items in category Rheumatoid Arthritis 118 items
• Overview Rheumatoid Arthritis and vitamin D which had the following summary Oct 2011
  FACT: People with Rheumatoid arthritis are often vitamin D deficient
  REPORT: People with the most Rheumatoid arthritis pain are the most vitamin D deficient
  FACT: Rheumatoid arthritis pain is reduced by vitamin D - sometimes as little as 500 IU
• Intervention - add vitamin D and see what happens
• Rheumatoid arthritis 24 % more likely if low vitamin D consumption– meta-analysis Sept 2012