A Systematic Review of Randomized, Double-Blind, Placebo-Controlled Trials Examining the Clinical Efficacy of Vitamin D in Multiple Sclerosis

Pozuelo-Moyano, Beatriz; Benito‐León, Julián; Mitchell, Alex J.; Hernández-Gallego, Jesús

doi:10.1159/000345122

Cited by 62 publications

(37 citation statements)

References 61 publications

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“…We could not identify any high-level evidence of vitamin D for the prevention of MS. Three systematic reviews/metaanalyses [65][66][67] have examined the effect of vitamin D on MS ( Table 6). The systematic reviews themselves have some methodological concerns.…”

Section: Belief 6: Vitamin D Can Treat Multiple Sclerosis (Ms) Observmentioning

confidence: 99%

Vitamin D: A Narrative Review Examining the Evidence for Ten Beliefs

Allan

Cranston²,

Lindblad

et al. 2016

J GEN INTERN MED

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Over the past decade, a large body of observational evidence has suggested an association between lower vitamin D status (25-hydroxyvitamin D) and multiple acute and chronic disorders, including cancer, multiple sclerosis, depression and respiratory tract infections. This evidence has fostered the hypothesis that increasing vitamin D intake may treat and prevent such disorders. Our objective was to perform a critical analysis of the highestlevel evidence for ten common beliefs regarding vitamin D for the prevention of falls, fractures and respiratory tract infections, the reduction of cancer incidence/mortality and overall mortality, and the prevention or treatment of depression/mental well-being, rheumatoid arthritis and multiple sclerosis, as well as maximum dosing and regular testing. We searched the Cochrane Database of Systematic Reviews and PubMed (up to August 2014) for randomized controlled trials and systematic reviews/ meta-analyses based on those studies. All searches were performed, all evidence reviewed and each section written by at least two authors. The evidence shows that vitamin D supplementation provides some benefit in fracture prevention (likely ∼10-15 % relative reduction), particularly at a dose ≥800 IU and with calcium; a likely benefit in the rate of falls, though it is less clear whether the number of fallers changes; and a possible small (∼5 %) relative reduction in mortality. Evidence does not support the use of vitamin D supplementation for the prevention of cancer, respiratory infections or rheumatoid arthritis. Similarly, evidence does not support vitamin D supplementation for the treatment of multiple sclerosis and rheumatoid arthritis or for improving depression/mental well-being. Regular testing of 25-hydroxyvitamin D is generally not required, and mega-doses (≥300,000 IU) appear to increase harms. Much of the evidence is at high risk of bias, with multiple flaws, including analyses of secondary endpoints, small and underpowered studies, inconsistent results and numerous other issues. Therefore, enthusiasm for a vitamin D panacea should be tempered.

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Section: Belief 6: Vitamin D Can Treat Multiple Sclerosis (Ms) Observmentioning

confidence: 99%

Vitamin D: A Narrative Review Examining the Evidence for Ten Beliefs

Allan

Cranston²,

Lindblad

et al. 2016

J GEN INTERN MED

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“…However, others reported no effect [149]. A recent systematic review of randomized, placebo double-blind trials assessing the beneficial of vitamin D administration in patients with multiple sclerosis was unable to reach a verdict with no significant effect seen in 4 out of 5 available trials [150]. Although there are limited studies looking at the effect of vitamin D intervention in children, most publications show a beneficial effect of vitamin D supplementation on reducing acute respiratory tract infections [151,152].…”

Section: Link Between Vitamin D and Immune Function - Evidence From Imentioning

confidence: 99%

Vitamin D and Its Effects on Glucose Homeostasis, Cardiovascular Function and Immune Function

et al. 2014

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In recent years there has been increasing interest in the non-skeletal effects of vitamin D. It has been suggested that vitamin D deficiency may influence the development of diabetes, cardiovascular dysfunction and autoimmune diseases. This review focuses on the current knowledge of the effects of vitamin D and its deficiency on cardiovascular function, glucose homeostasis and immune function, with a particular focus on children. Although, there is good evidence to show that there is an association between vitamin D deficiency and an abnormality of the above systems, there is little evidence to show that vitamin D supplementation leads to an improvement in function, especially in childhood.

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“…12 Other preliminary data seem to indicate that low serum levels of 25-hydroxy vitamin D may predict an adverse prognosis in recently diagnosed patients with MS. 13 It will be prudent for the physician to ensure that testing for vitamin D levels (vitamin D 25 hydroxy, including fractions) will be reimbursed for a diagnosis of MS or as a screening procedure. While many health insurers might pay for this test, not all of them would recognize MS or screening as covered indications.…”

Section: Cannabismentioning

confidence: 99%

Complementary and alternative medicine in multiple sclerosis

2015

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SummaryThis article identifies payment policy perspectives of the American Academy of Neurology's guideline on complementary and alternative medicine (CAM) in multiple sclerosis (MS). The guideline is a reliable repository of information for advocating or not recommending certain CAM treatments in MS. It eases the burden of searching for information on each separate CAM treatment. It frequently emphasizes the need for patient counseling. To provide such generally undervalued, but needed, cognitive services, neurologists could use advanced practice providers and patientfriendly visual aids during or between visits. They should also rely on evaluation and management codes that recognize time spent predominantly on counseling or coordination of care. The guideline's categorization of probable effectiveness of certain therapies will not influence coverage decisions because payers do not generally cover CAM therapies.T his article identifies payment policy perspectives resulting from the series of recommendations put forward in the American Academy of Neurology (AAN)'s evidence-based guideline on complementary and alternative medicine (CAM) in MS.1 CAM therapies are sometimes used to relieve symptoms in persons with multiple sclerosis (MS).

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A Systematic Review of Randomized, Double-Blind, Placebo-Controlled Trials Examining the Clinical Efficacy of Vitamin D in Multiple Sclerosis

Cited by 62 publications

References 61 publications

Vitamin D: A Narrative Review Examining the Evidence for Ten Beliefs

Vitamin D: A Narrative Review Examining the Evidence for Ten Beliefs

Vitamin D and Its Effects on Glucose Homeostasis, Cardiovascular Function and Immune Function

Complementary and alternative medicine in multiple sclerosis

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