Abstract
Background: The aim of this study is to evaluate the clinical efficacy of vitamin D (VitD) supplementation in terms of response to treatment and improvement of disease activity in rheumatoid arthritis (RA).Methods: This study analyzed 1180 RA patients' records treated at Mianyang Central Hospital from February 2015 to July 2019. The patients were allocated into VitD group and control group based on their medical regimens. The outcome measures were primary efficacy, defined as treatment response-based EULAR response criteria in RA, and secondary efficacy, defined as improvement in disease activity indicators. Safety was evaluated according to the incidence of all-cause infections.Results: At month 6, the primary efficacy revealed that there were 22.8% good responders and 19.0% moderate responders in the VitD group, and 22.3% good responders and 22.3% moderate responders in the control group; there were no differences between the two groups (p = 0.754). The similar primary efficacy outcomes were observed at months 3, 12, and >12. The secondary efficacy indicated that there were no differences in most indexes between the two groups at months 1, 3, 6, 12, and >12. The subgroups (based on baseline DAS28 (CRP), glucocorticoids use and disease duration) analysis results suggested that VitD group didn't have the advantage for treating RA. The incidence of infections was similar in the two groups.Conclusion: VitD supplementation did not provide additional benefit for anti-rheumatic treatment. These data supported the need for prospective, randomized, controlled trials to evaluate the role of VitD supplementation in treating RA.
Highlights
Rheumatoid arthritis (RA) is a progressive and chronic inflammatory joint disease with cartilage and bone damage that leads to disability [1]
Vitamin D for RA Treatment glucocorticoids, anti-inflammatory drugs, conventional synthetic disease-modifying antirheumatic drugs, and targeted synthetic DMARDs [4], some patients still do not respond to these treatments
An exploratory study suggested that vitamin D (VitD) supplementation improved 28 joint disease activity scores based on C-reactive protein (DAS28 (CRP)) in patients without VitD deficiency but did not affect patients with VitD deficiency at baseline [14]
Summary
Rheumatoid arthritis (RA) is a progressive and chronic inflammatory joint disease with cartilage and bone damage that leads to disability [1]. Vitamin D (VitD) deficiency, as an environmental risk factor, is significantly associated with high disease activity and neuropathic pain in RA patients [5,6,7]. An exploratory study suggested that VitD supplementation improved 28 joint disease activity scores based on C-reactive protein (DAS28 (CRP)) in patients without VitD deficiency but did not affect patients with VitD deficiency at baseline [14]. Another study reported that VitD supplementation for more than 3 months could significantly improve disease activity in patients with persistent disease activity and VitD deficiency [16]. The clinical efficacy of VitD supplementation on the response to treatment of disease activity in RA remains unclear. The aim of this study is to evaluate the clinical efficacy of vitamin D (VitD) supplementation in terms of response to treatment and improvement of disease activity in rheumatoid arthritis (RA)
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