Efficacy and Safety of Vitamin D Supplementation in Patients With Systemic Lupus Erythematosus: A Meta-analysis of Randomized Controlled Trials

Zheng, Ronghao; Gonzalez, Alex; Yuan, Jun; Wu, Xiaolin; Qiu, Ming; Gui, Lin; Zhu, Songbai; Huang, Li

doi:10.1016/j.amjms.2019.04.020

Cited by 37 publications

(28 citation statements)

References 31 publications

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“…Our study showed that VD supplementation is comparatively safe and significantly increases the levels of serum 25(OH)VD in patients with SLE, even though, VD supplements do not appear to significantly decrease the positivity of anti-dsDNA and SLE activity (Table 4), this is in agreement with Zheng et al [26]. Another interesting observation in our study is the inverse correlation between serum levels of VD and clinical symptoms in SLE patients including mucocutaneous, malar rash, and renal symptoms.…”

Section: Discussionsupporting

confidence: 92%

Vitamin D in active systemic lupus erythematosus and lupus nephritis: a forgotten player

2020

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Background Systemic lupus erythematosus (SLE) is an autoimmune disorder associated with immunological abnormalities (Aringer et al., Arthritis Rheumatol 71:1400-1412, 2019). Vitamin D (VD) has an important role in SLE pathogenesis, as it controls cell cycle progression besides its anti-proliferative effects (Liu et al., J Cell Commun Signal 71, 2019). Determining the relationship between VD with SLE activity and lupus nephritis (LN) can establish a new role for VD in SLE management (Liu et al., J Cell Commun Signal 71, 2019). In our study, we aimed to assess the relationship between levels of VD in patients with SLE activity and with LN and to verify the relationship between VD levels with clinical and laboratory parameters in those patients, in order to assess the validity of adding serum VD level in the routine follow-up as a marker that may lead to earlier diagnosis of SLE activity and LN in adult SLE patients. Results Serum VD was significantly lower in SLE patients (3.38 ± 2.55 ng/ml) versus healthy controls (5.36 ± 2.88 ng/ml) (P < 0.002). Interestingly, serum VD was significantly lower in patient with active SLE according to SLEDAI (3.00 ± 2.27 ng/ml) versus those with inactive SLE (5.10 ± 3.19 ng/ml) (P < 0.02). Significant negative correlation was found between serum level of VD and each of mucocutaneous, malar rash, and renal manifestations. Significant negative correlation was also noticed among SLEDAI (P value = 0.01) and renal SLEDAI scores (P value = 0.021) with serum level of VD. Conclusion Low levels of VD were found to be frequent in SLE patients especially during phases of SLE activity and nephritis. Potent markers of low serum VD level in SLE patients were found to be mucocutaneous, malar rash, and LN. Our results support that VD levels could act as independent risk factors for activity and LN in SLE patients; moreover, treatment with VD supplementation could decrease the incidence of activity and nephritis in SLE patients.

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Section: Discussionsupporting

confidence: 92%

Vitamin D in active systemic lupus erythematosus and lupus nephritis: a forgotten player

2020

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“…This finding highlights NMDAR ( N -methyl- D -aspartate) autoantibodies as a potential biomarker for fatigue in SLE and also provides a plausible explanation of belimumab efficacy in the treatment of fatigue, as observed in BLISS trials [ 36 ]. Physical activity and vitamin D supplementation [ 92 ] have also been shown to improve fatigue levels in patients with SLE. Despite these findings, relieving fatigue remains an unmet need for lupus patients and a challenge for their physicians, and new effective approaches are needed.…”

Section: What Has Already Been Done and What Remains To Domentioning

confidence: 99%

Systemic Lupus Erythematosus (SLE) Therapy: The Old and the New

et al. 2020

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Despite recent improvements in the treatment of systemic lupus erythematosus (SLE), disease activity, comorbidities and drug toxicity significantly contribute to the risk of progressive irreversible damage accrual and increased mortality in patients with this chronic disease. Moreover, even lupus patients in remission often report residual symptoms, such as fatigue, which have a considerable impact on their health-related quality of life. In recent decades, SLE treatment has moved from the use of hydroxychloroquine, systemic glucocorticosteroids and conventional immunosuppressive drugs to biologic agents, of which belimumab is the first and only biologic agent approved for the treatment for SLE to date. Novel therapies targeting interferons, cytokines and their receptors, intracellular signals, plasma cells, T lymphocytes and co-stimulatory molecules are being evaluated. In the context of a holistic approach, growing evidence is emerging of the importance of correct lifestyle habits in the management of lupus manifestations and comorbidities. The aim of this paper is to provide an overview of current pharmacological and non-pharmacological treatment options and emerging therapies in SLE.

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“…56 This is contrary to systemic lupus erythematosus (SLE), where data suggest that vitamin D supplementation may improve fatigue. 71…”

Section: Treatmentmentioning

confidence: 99%

Management of Fatigue in Rheumatoid Arthritis

Pope

2020

RMD Open

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Fatigue in rheumatoid arthritis is highly prevalent. It is correlated only weakly with disease activity but more so with pain, mood, personality features, poor sleep, obesity and comorbidities. Fatigue can be measured by many standardised questionnaires and more easily with a Visual Analogue Scale or numeric rating scale. Most patients with RA have some fatigue, and at least one in six have severe fatigue. Chronic pain and depressed mood are also common in RA patients with significant fatigue. It affects function and quality of life and is worse on average in women. Evidence-based treatment for fatigue includes treatment of underlying disease activity (with on average modest improvement of fatigue), exercise programmes and supervised self-management programmes with cognitive-behavioural therapy, mindfulness and reinforcement (such as reminders). The specific programmes for exercise and behavioural interventions are not standardised. Some medications cause fatigue such as methotrexate. More research is needed to understand fatigue and how to treat this common complex symptom in RA that can be the worst symptom for some patients.

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Efficacy and Safety of Vitamin D Supplementation in Patients With Systemic Lupus Erythematosus: A Meta-analysis of Randomized Controlled Trials

Cited by 37 publications

References 31 publications

Vitamin D in active systemic lupus erythematosus and lupus nephritis: a forgotten player

Vitamin D in active systemic lupus erythematosus and lupus nephritis: a forgotten player

Systemic Lupus Erythematosus (SLE) Therapy: The Old and the New

Management of Fatigue in Rheumatoid Arthritis

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