Beneficial role for supplemental vitamin D3 treatment in chronic urticaria: a randomized study

Rorie, Andrew; Goldner, Whitney; Lyden, Elizabeth; Poole, Jill

doi:10.1016/j.anai.2014.01.010

Cited by 52 publications

(78 citation statements)

References 28 publications

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“…Urticaria symptoms were recorded at weeks 1, 6 and 12 in addition to tracking the number of medication pills required to control symptoms. There was a 33% reduction in total urticaria severity score (USS) at 1 week post-enrollment in both treatment groups [13]. Importantly, there was a further significant reduction (~40%) in total USS in subjects treated with high-dose, but not low-dose, vitamin D supplementation at 3 months compared to 1 week post-enrollment.…”

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confidence: 80%

“…In addition, the measured serum 25(OH)D levels correlated with the USS. There were also no significant adverse events with high (or low) vitamin D dosing in these subjects [13].These few studies do provide evidence of a potential relationship between chronic urticaria and vitamin D; however, these studies are small with only one randomized controlled clinical trial reported in the literature. Our randomized, interventional study was limited in the number of subjects, and importantly, limited in subject diversity that was predominately overweight-obese, Caucasian females [13].…”

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confidence: 85%

“…In addition, the measured serum 25(OH)D levels correlated with the USS. There were also no significant adverse events with high (or low) vitamin D dosing in these subjects [13].…”

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confidence: 90%

“…In 2011, Goetz reported in a retrospective case series that 70% of subjects with chronic urticaria (n = 57) had treatment success of their idiopathic urticaria with supplementation of vitamin D 50,000 IU weekly followed by daily supplementation [11]. Sindher and colleagues reported in a case report that a 58-year-old man with chronic urticaria and severe vitamin D deficiency (25(OH)D level 4.7 ng/ml) had complete resolution of his symptoms after supplementation of vitamin D with repeat 25(OH)D level of 65 ng/ml [12].In early 2014, we reported on potential benefits of vitamin D supplementation in subjects with chronic urticaria in the first double-blind, randomized controlled clinical trial to our knowledge [13]. A total of 42 adult subjects with chronic urticaria were enrolled with or without baseline vitamin D deficiency to either a high-dose (4000 IU) or low-dose (600 IU) vitamin D 3 supplement daily for 12 weeks.…”

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confidence: 99%

“…In early 2014, we reported on potential benefits of vitamin D supplementation in subjects with chronic urticaria in the first double-blind, randomized controlled clinical trial to our knowledge [13]. A total of 42 adult subjects with chronic urticaria were enrolled with or without baseline vitamin D deficiency to either a high-dose (4000 IU) or low-dose (600 IU) vitamin D 3 supplement daily for 12 weeks.…”

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confidence: 99%

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Vitamin D supplementation: a potential booster for urticaria therapy

Rorie

Poole

2014

Expert Review of Clinical Immunology

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Chronic urticaria is a common skin condition whereby the etiology remains largely idiopathic and the mainstay therapy is symptomatic control with antihistamines. There have been a limited number of small studies suggesting a potential role for vitamin D in chronic urticaria, and this this editorial review will discuss the current supporting evidence. Associations for decreased serum vitamin 25 hydroxyvitamin D levels in subjects with chronic urticaria have been reported. In addition to observational reports, there has been a randomized, prospective, blinded trial demonstrating symptom improvement when high vitamin D3 supplementation was utilized as an add-on therapy for urticarial management. More research is needed to address mechanisms of action and to investigate vitamin D supplementation in larger and longer duration human trials.Chronic urticaria is a skin condition that is defined as experiencing urticarial wheals daily or nearly daily for a duration of greater than 6 weeks. The lifetime prevalence of this disorder in the general population is 1-3% and may dramatically impair the quality of life [1,2]. The underlying etiology of these skin manifestations is a complex interaction of inflammatory and allergic mediators in the peripheral tissue milieu. There are multiple subtypes of chronic urticaria that include physical, idiopathic, autoimmune, vasculitic and infectious. Autoimmune etiologies account for 30-60% of chronic urticaria with the presence of functional autoantibodies to the high affinity IgE receptor or IgE, and up to 12% are associated with thyroid autoantibodies such as antithyroid peroxidase antibody and antimicrosomal antibody. Approximately 50% of cases of chronic urticaria remain largely idiopathic [1,3].The association between vitamin D and multiple medical conditions has been receiving much attention, which was well summarized by Holick in 2007 [4]. He reviewed the potential associations with vitamin D deficiency in a variety of solid tumors, arthritis, transplant rejection, and autoimmune diseases including Crohn's disease, multiple sclerosis and type 1 diabetes [4]. However, large randomized controlled trials are largely lacking to validate these potential associations. In fact, in early 2014 a systemic review of randomized trials assessing the role of vitamin D supplementation in various medical conditions failed to demonstrate significant benefit for vitamin D, with the exception of reduced all-cause mortality in elderly women [5]. However, there is a growing body of evidence linking vitamin D with allergic diseases. Notably, in 2007, Camargo et al. published a study tracking the regional distribution of 2.5 million epinephrine pens prescribed in a calendar year in the USA [6]. They reported significantly more prescriptions and filled prescriptions in the northern states, with a strong north to south gradient. The authors proposed that sunlight exposure was the important factor because this north-south gradient was demonstrated despite controlling for variables such as population, num...

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confidence: 80%

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confidence: 85%

“…In addition, the measured serum 25(OH)D levels correlated with the USS. There were also no significant adverse events with high (or low) vitamin D dosing in these subjects [13].…”

mentioning

confidence: 90%

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confidence: 99%

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confidence: 99%

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