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Role of vitamin D in flare ups of rheumatoid arthritis

Rolle von Vitamin D bei Schüben der rheumatoiden Arthritis

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Abstract

Introduction

Rheumatoid arthritis (RA) is one of the most prevalent autoimmune diseases worldwide. Some researchers have suggested that the serum vitamin D (Vit D) level may relate to disease activity. The current study was designed to identify the correlation between vitamin D prescription and prevention of relapses in rheumatoid arthritis.

Patients and method

A double blinded, randomized controlled trial study was performed using 80 RA patients. RA was controlled and patients were in remission during the past 2 months. Serum level of Vit D in the studied patients was below 30 ng/dl. Patients were randomly allocated to receive Vit D or placebo. In the 6-month follow-up period, the Disease Activity Score 28 (DAS28) was used in case of relapses as an index of RA activity to compare the two groups.

Results

The flare rate was not different between two groups (p > 0.05). The odds ratio of the rate of decline in patients of the trial group compared with the control group was 1.17 (not significant; p > 0.05). The mean DAS28 between the two patient groups was not significant (p > 0.05).

Conclusion

A low Vit D level was not identified to be a risk factor for RA severity or flare ups; however, although not statistically significant, Vit D treatment might be clinically effective. Further studies are needed with more emphasis on the issue of cost effectiveness and clinical importance to provide more information.

Zusammenfassung

Einleitung

Die rheumatoide Arthritis (RA) gehört weltweit zu den häufigsten Autoimmunerkrankungen. Manche Forscher vermuten, dass die Aktivität der Erkrankung mit dem Vitamin-D-Spiegel im Serum zusammenhängt. In der vorliegenden Studie sollte die Beziehung zwischen der Verschreibung von Vitamin D und der Prävention von RA-Rezidiven ermittelt werden.

AbstractSection Stop

Patienten und Methoden

An 80 RA-Patienten wurde eine doppelblinde, randomisierte, kontrollierte Studie durchgeführt. Die Erkrankung war unter Kontrolle, die Patienten hatten sich in den vorausgegangenen 2 Monaten in Remission befunden. Der Serum-Vitamin-D-Spiegel lag bei den eingeschlossenen Patienten unter 30 ng/dl. Die Teilnehmer wurden in 2 Gruppen randomisiert. Eine erhielt Vitamin D, die andere Placebo. Im 6-monatigen Follow-up wurde im Falle eines Rezidivs der Disease Activity Score 28 (DAS28) herangezogen, um die beiden Gruppen bezüglich der RA-Aktivität zu vergleichen.

Ergebnisse

Die Gruppen unterschieden sich nicht hinsichtlich der Rate an Schüben (p > 0,05). Die Odds Ratio der Abnahme betrug für Patienten in der behandelten Gruppe im Vergleich zur Kontrollgruppe 1,17 (nicht signifikant; p > 0,05). Auch hinsichtlich des durchschnittlichen DAS28 fand sich in den beiden Gruppen keine Signifikanz (p > 0,05).

Schlussfolgerung

Ein niedriger Vitamin-D-Spiegel erwies sich nicht als Risikofaktor für Schübe oder die Schwere der RA. Allerdings könnte die Vitamin-D-Behandlung, wenn auch ohne statistische Signifikanz, klinisch wirksam sein. Weitere Studien mit stärkerem Gewicht auf der Kosteneffektivität und klinischen Bedeutung sind notwendig.

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Acknowledgment

This project was supported by faculty of medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran as the dissertation of Dr. Shahab Rahimpour to graduate in internal medicine. We also are thankful to Dr. Masoud Rahimian and Dr. Mohammad Reza Mirjalili for their consultations.

Compliance with ethical guidelines

Conflict of interest. A. Dehghan, S. Rahimpour, H. Soleymani-Salehabadi, and M. Bagher Owlia state that there are no conflicts of interest.

All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

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Authors and Affiliations

  1. Rheumatology, Department of Internal Medicine, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

    A. Dehghan, H. Soleymani-Salehabadi & M.B. Owlia

  2. Resident in Internal Medicine, department of Internal Medicine, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Ibn Sina Blvd, Ghandi Blvd, Safaieh, Yazd, Iran

    S. Rahimpour

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  1. A. Dehghan
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  2. S. Rahimpour
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Correspondence to S. Rahimpour.

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Dehghan, A., Rahimpour, S., Soleymani-Salehabadi, H. et al. Role of vitamin D in flare ups of rheumatoid arthritis. Z. Rheumatol. 73, 461–464 (2014). https://doi.org/10.1007/s00393-013-1297-4

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