Abstract
Randomized controlled trials have suggested that vitamin D supplementation can prevent asthma and chronic obstructive pulmonary disease (COPD) exacerbations. For COPD, the benefit appears to be limited to individuals with baseline 25-hydroxyvitamin D (25OHD) levels <25 nmol/L. We performed a post hoc analysis of data from a randomized, double-blinded, placebo-controlled trial to investigate the effect that monthly, high-dose vitamin D supplementation (versus placebo) had on older adults with asthma and/or COPD. Specifically, we investigated whether vitamin D supplementation prevented exacerbations of these conditions. Participants were randomly assigned either to an initial oral dose of 200,000 IU vitamin D3 followed by 100,000 IU monthly or to placebo, with an average follow-up period of 3.3 years. Among the 5110 participants, 775 had asthma or COPD at the beginning of the study, and were eligible for inclusion in this analysis. Exacerbations were defined by the prescription of a short-burst of oral corticosteroids. The mean age of the participants was 67 years old, and 56% were male. The mean baseline blood 25OHD level was 63 nmol/L; 2.3% were <25 nmol/L. Overall, we found that vitamin D supplementation did not affect the exacerbation risk (hazard ratio 1.08; 95%CI 0.84–1.39). Among those with baseline 25OHD <25 nmol/L, however, the hazard ratio was 0.11 (95%CI 0.02–0.51); p for interaction = 0.001. Although monthly vitamin D supplementation had no overall impact on risk of exacerbations of asthma or COPD, we found evidence of a probable benefit among those with severe vitamin D deficiency.
Highlights
Among older adults, asthma and chronic obstructive pulmonary disease (COPD) are two major obstructive airway diseases that can be difficult to distinguish, and that may coexist as asthma-COPD overlap syndrome [1]
Given the beneficial effect that vitamin D supplementation has on acute respiratory infections (ARI) [5], a growing number of researchers have investigated whether vitamin
In a 2017 individual participant data (IPD) meta-analysis of all known randomized controlled trials (RCTs) worldwide, Jolliffe and colleagues demonstrated that vitamin D supplements can reduce the risk of asthma exacerbations requiring systemic corticosteroids, especially among those with baseline serum hydroxyvitamin D (25OHD) levels
Summary
Asthma and chronic obstructive pulmonary disease (COPD) are two major obstructive airway diseases that can be difficult to distinguish, and that may coexist as asthma-COPD overlap syndrome [1]. Both are chronic diseases characterized by periodic exacerbations, which are usually triggered by respiratory virus infections [2]. In a 2017 individual participant data (IPD) meta-analysis of all known randomized controlled trials (RCTs) worldwide, Jolliffe and colleagues demonstrated that vitamin D supplements can reduce the risk of asthma exacerbations requiring systemic corticosteroids, especially among those with baseline serum hydroxyvitamin D (25OHD) levels
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