The Role of Vitamin D in Combination Treatment for Patients With Rheumatoid Arthritis

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.

Involvement of the secosteroid vitamin D in autoimmune rheumatic diseases and COVID-19

“…Furthermore, in a small cohort of 61 patients with RA, supplementation with vitamin D (100,000 IU per month) resulted in a significant reduction in DAS28 in patients with sufficient basal serum concentrations of vitamin D and VAS in patients with deficient basal serum concentrations of vitamin D 125 . Conversely, some investigations have found no significant clinical benefit after vitamin D supplementation 126 – 130 .…”

Non-causal Effect of Circulating Vitamin D Levels on the Risk of Rheumatoid Arthritis: A Two-sample Mendelian Randomization Study

“…A study showed that treatment with vitamin D supplementation in RA patients with secondary osteoporosis could effectively increase bone mineral density [29]. Nevertheless, a study involving 1180 individuals indicated that vitamin D supplementation did not provide other bene ts for anti-rheumatic therapy [30]. The speci c roles of vitamin D in the pathology of RA and whether vitamin D supplementation is effective remains to be con rmed in the future.…”

The Immunologic Profile of Vitamin D and Its Role in Different Immune-Mediated Diseases: An Expert Opinion

“…The most important point is the demonstrated different effects of cholecalciferol on DAS28 and VAS depending on baseline 25(OH)D levels: The most beneficial effects of cholecalciferol on DAS28 were found in patients with baseline 25(OH)D > 20 ng/mL, while its greatest effects on VAS were in patients with baseline 25(OH)D < 20 ng/mL [ 99 ]. However, in a recent study analyzing 1180 RA patient records, vitamin D supplementation did not provide additional benefit for anti-rheumatic treatment [ 100 ]. These data support the need for prospective, randomized, controlled trials (RCTs) to evaluate the role of vitamin D supplementation in treating RA.…”