High doses of vitamin D to reduce exacerbations in chronic obstructive pulmonary disease: a randomized trial.
Ann Intern Med
; 156(2): 105-14, 2012 Jan 17.
Article
em En
| MEDLINE
| ID: mdl-22250141
ABSTRACT
BACKGROUND:
Low serum 25-hydroxyvitamin D (25-[OH]D) levels have been associated with lower FEV(1), impaired immunologic control, and increased airway inflammation. Because many patients with chronic obstructive pulmonary disease (COPD) have vitamin D deficiency, effects of vitamin D supplementation may extend beyond preventing osteoporosis.OBJECTIVE:
To explore whether supplementation with high doses of vitamin D could reduce the incidence of COPD exacerbations.DESIGN:
Randomized, single-center, double-blind, placebo-controlled trial. (ClinicalTrials.gov registration number NCT00666367)SETTING:
University Hospitals Leuven, Leuven, Belgium. PATIENTS 182 patients with moderate to very severe COPD and a history of recent exacerbations. INTERVENTION 100,000 IU of vitamin D supplementation or placebo every 4 weeks for 1 year. MEASUREMENTS The primary outcome was time to first exacerbation. Secondary outcomes were exacerbation rate, time to first hospitalization, time to second exacerbation, FEV(1), quality of life, and death.RESULTS:
Mean serum 25-(OH)D levels increased significantly in the vitamin D group compared with the placebo group (mean between-group difference, 30 ng/mL [95% CI, 27 to 33 ng/mL]; P < 0.001). The median time to first exacerbation did not significantly differ between the groups (hazard ratio, 1.1 [CI, 0.82 to 1.56]; P = 0.41), nor did exacerbation rates, FEV(1), hospitalization, quality of life, and death. However, a post hoc analysis in 30 participants with severe vitamin D deficiency (serum 25-[OH]D levels <10 ng/mL) at baseline showed a significant reduction in exacerbations in the vitamin D group (rate ratio, 0.57 [CI, 0.33 to 0.98]; P = 0.042).LIMITATION:
This was a single-center study with a small sample size.CONCLUSION:
High-dose vitamin D supplementation in a sample of patients with COPD did not reduce the incidence of exacerbations. In participants with severe vitamin D deficiency at baseline, supplementation may reduce exacerbations. PRIMARY FUNDING SOURCE Applied Biomedical Research Program, Agency for Innovation by Science and Technology (IWT-TBM).
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Vitamina D
/
Suplementos Nutricionais
/
Doença Pulmonar Obstrutiva Crônica
Tipo de estudo:
Clinical_trials
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article