Skip to main content
Erschienen in: Digestive Diseases and Sciences 2/2017

14.12.2016 | Original Article

Impact of High-Dose Vitamin D3 Supplementation in Patients with Crohn’s Disease in Remission: A Pilot Randomized Double-Blind Controlled Study

verfasst von: Neeraj Narula, Mohan Cooray, Rebecca Anglin, Zack Muqtadir, Alisha Narula, John K. Marshall

Erschienen in: Digestive Diseases and Sciences | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Aim

To assess the tolerability and efficacy of high-dose vitamin D3 in patients with Crohn’s disease (CD).

Methods

This was a randomized, double-blind placebo-controlled trial of high-dose vitamin D3 at 10,000 IU daily (n = 18) compared to 1000 IU daily (n = 16) for 12 months in patients with CD in remission. The primary outcome was change in serum 25-hydroxy-vitamin D levels. Secondary outcomes included clinical relapse rates and changes in mood scores.

Results

High-dose vitamin D3 at 10,000 IU daily significantly improved 25-hydroxy-vitamin D levels from a mean of 73.5 nmol/L [standard deviation (SD) 11.7 nmol/L] to 160.8 nmol/L (SD 43.2 nmol/L) (p = 0.02). On an intention-to-treat basis, the rate of relapse was not significantly different between patients receiving low- and high-dose vitamin D3 (68.8 vs 33.3%, p = 0.0844). In per-protocol analysis, clinical relapse of Crohn’s disease was less frequently observed in patients receiving a high dose (0/12 or 0%) compared to those receiving a low dose of 1000 IU daily (3/8 or 37.5%) (p = 0.049). Improvement in anxiety and depression scores and a good safety profile were observed in both groups treated with vitamin D3.

Conclusions

Oral supplementation with high-dose vitamin D3 at 10,000 IU daily significantly improved serum 25-hydroxy-vitamin D levels. Rates of clinical relapse were similar between both groups. Larger studies using high-dose vitamin D3 for treatment of inflammatory bowel diseases are warranted.

Clinicaltrials.gov registration no

NCT02615288.
Literatur
1.
Zurück zum Zitat Peyrin-Biroulet L, Oussalah A, Bigard M. Crohn’s disease: the hot hypothesis. Med Hypotheses. 2009;79:94–96.CrossRef Peyrin-Biroulet L, Oussalah A, Bigard M. Crohn’s disease: the hot hypothesis. Med Hypotheses. 2009;79:94–96.CrossRef
2.
Zurück zum Zitat Jørgensen S, Agnholt J, Glerup H. Clinical trial: vitamin D3 treatment in Crohn’s disease—a randomized double-blind placebo-controlled study. Aliment Pharmacol Ther. 2010;32:377–383.CrossRefPubMed Jørgensen S, Agnholt J, Glerup H. Clinical trial: vitamin D3 treatment in Crohn’s disease—a randomized double-blind placebo-controlled study. Aliment Pharmacol Ther. 2010;32:377–383.CrossRefPubMed
3.
Zurück zum Zitat Sambrook P, Birmingham J, Kelly P, et al. Prevention of corticosteroid osteoporosis: a comparison of calcium, calcitriol and calcitonin. N Engl J Med. 1993;328:1747–1752.CrossRefPubMed Sambrook P, Birmingham J, Kelly P, et al. Prevention of corticosteroid osteoporosis: a comparison of calcium, calcitriol and calcitonin. N Engl J Med. 1993;328:1747–1752.CrossRefPubMed
4.
Zurück zum Zitat Gorham E, Garland C, Garland F, et al. Vitamin D and the prevention of colorectal cancer. J Steroid Biochem Mol Biol. 2005;97:179–194.CrossRefPubMed Gorham E, Garland C, Garland F, et al. Vitamin D and the prevention of colorectal cancer. J Steroid Biochem Mol Biol. 2005;97:179–194.CrossRefPubMed
5.
Zurück zum Zitat Wilkins C, Sheline Y, Roe C, et al. Vitamin D deficiency is associated with low mood and worse cognitive performance in older adults. Am J Geriatr Psychiatry. 2006;14:1032–1040.CrossRefPubMed Wilkins C, Sheline Y, Roe C, et al. Vitamin D deficiency is associated with low mood and worse cognitive performance in older adults. Am J Geriatr Psychiatry. 2006;14:1032–1040.CrossRefPubMed
6.
Zurück zum Zitat Burton J, Kimball S, Vieth R, et al. A phase I/II dose-escalation trial of vitamin D3 and calcium in multiple sclerosis. Neurology. 2010;74:1852–1859.CrossRefPubMedPubMedCentral Burton J, Kimball S, Vieth R, et al. A phase I/II dose-escalation trial of vitamin D3 and calcium in multiple sclerosis. Neurology. 2010;74:1852–1859.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Goldberg P, Fleming M, Picard E. Multiple sclerosis: decreased relapse rate through dietary supplementation with calcium, magnesium, and vitamin D. Med Hypotheses. 1986;21:193–200.CrossRefPubMed Goldberg P, Fleming M, Picard E. Multiple sclerosis: decreased relapse rate through dietary supplementation with calcium, magnesium, and vitamin D. Med Hypotheses. 1986;21:193–200.CrossRefPubMed
8.
Zurück zum Zitat Boothe D, Lakehomer H, Jacob V et al. High dose vitamin D3 improves clinical activity in Crohn’s disease. American College of Gastroenterology Annual Meeting 2011; Washington, DC; 2011. Boothe D, Lakehomer H, Jacob V et al. High dose vitamin D3 improves clinical activity in Crohn’s disease. American College of Gastroenterology Annual Meeting 2011; Washington, DC; 2011.
9.
Zurück zum Zitat Fishbane S, Shapiro WB, Corry DB, et al. Cinacalcet HCl and concurrent low-dose vitamin D improves treatment of secondary hyperparathyroidism in dialysis patients compared with vitamin D alone: the ACHIEVE study results. Clin J Am Soc Nephrol. 2008;3:1718–1725.CrossRefPubMedPubMedCentral Fishbane S, Shapiro WB, Corry DB, et al. Cinacalcet HCl and concurrent low-dose vitamin D improves treatment of secondary hyperparathyroidism in dialysis patients compared with vitamin D alone: the ACHIEVE study results. Clin J Am Soc Nephrol. 2008;3:1718–1725.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Mann MC, Exner DV, Hemmelgarn BR, et al. The VITAH trial vitamin D supplementation and cardiac autonomic tone in hemodialysis: a blinded, randomized controlled trial. BMC Nephrol. 2014;15:129.CrossRefPubMedPubMedCentral Mann MC, Exner DV, Hemmelgarn BR, et al. The VITAH trial vitamin D supplementation and cardiac autonomic tone in hemodialysis: a blinded, randomized controlled trial. BMC Nephrol. 2014;15:129.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Puhan MA, Frey M, Buchi S, et al. The minimal important difference of the hospital anxiety and depression scale in patients with chronic obstructive pulmonary disease. Health Qual Life Outcomes. 2008;6:46.CrossRefPubMedPubMedCentral Puhan MA, Frey M, Buchi S, et al. The minimal important difference of the hospital anxiety and depression scale in patients with chronic obstructive pulmonary disease. Health Qual Life Outcomes. 2008;6:46.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Cranney A, Weiler HA, O’Donnell S, et al. Summary of evidence-based review on vitamin D efficacy and safety in relation to bone health. Am J Clin Nutr. 2008;88:513A–519S. Cranney A, Weiler HA, O’Donnell S, et al. Summary of evidence-based review on vitamin D efficacy and safety in relation to bone health. Am J Clin Nutr. 2008;88:513A–519S.
14.
Zurück zum Zitat Raftery T, Martineau AR, Greiller CL, et al. Effects of vitamin D supplementation on intestinal permeability, cathelicidin and disease marrkers in Crohn’s disease: results from a randomised double-blind placebo-controlled study. United Euro Gastroenterol J. 2015;3:294–302.CrossRef Raftery T, Martineau AR, Greiller CL, et al. Effects of vitamin D supplementation on intestinal permeability, cathelicidin and disease marrkers in Crohn’s disease: results from a randomised double-blind placebo-controlled study. United Euro Gastroenterol J. 2015;3:294–302.CrossRef
15.
Zurück zum Zitat Zhao H, Zhang H, Wu H, et al. Protective role of 1,25(OH)2 vitamin D3 in the mucosal injury and epithelial barrier disruption in DSS-induced acute colitis in mice. BMC Gastroenterol. 2012;12:57.CrossRefPubMedPubMedCentral Zhao H, Zhang H, Wu H, et al. Protective role of 1,25(OH)2 vitamin D3 in the mucosal injury and epithelial barrier disruption in DSS-induced acute colitis in mice. BMC Gastroenterol. 2012;12:57.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Yang L, Weaver V, Smith JP, et al. Therapeutic effect of vitamin D supplementation in a pilot study of Crohn’s patients. Clin Trans Gastroenterol. 2013;4:e33.CrossRef Yang L, Weaver V, Smith JP, et al. Therapeutic effect of vitamin D supplementation in a pilot study of Crohn’s patients. Clin Trans Gastroenterol. 2013;4:e33.CrossRef
17.
Zurück zum Zitat Vieth R, Kimball S, Hu A, et al. Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and wellbeing of patients. Nutr J. 2004;3:8.CrossRefPubMedPubMedCentral Vieth R, Kimball S, Hu A, et al. Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and wellbeing of patients. Nutr J. 2004;3:8.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Jorde R, Sneve M, Figenschau Y, et al. Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. J Intern Med. 2008;264:599–609.CrossRefPubMed Jorde R, Sneve M, Figenschau Y, et al. Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. J Intern Med. 2008;264:599–609.CrossRefPubMed
19.
Zurück zum Zitat Addolorato G, Capristo E, Stefanini G, et al. Inflammatory bowel disease: a study of the association between anxiety and depression, physical morbidity, and nutritional status. Scand J Gastroenterol. 1997;32:1013–1021.CrossRefPubMed Addolorato G, Capristo E, Stefanini G, et al. Inflammatory bowel disease: a study of the association between anxiety and depression, physical morbidity, and nutritional status. Scand J Gastroenterol. 1997;32:1013–1021.CrossRefPubMed
20.
Zurück zum Zitat Farrokhyar F, Marshall J, Easterbrook B, et al. Functional gastrointestinal disorders and mood disorders in patients with inactive inflammatory bowel disease: prevalence and impact on health. Inflamm Bowel Dis. 2006;12:38–46.CrossRefPubMed Farrokhyar F, Marshall J, Easterbrook B, et al. Functional gastrointestinal disorders and mood disorders in patients with inactive inflammatory bowel disease: prevalence and impact on health. Inflamm Bowel Dis. 2006;12:38–46.CrossRefPubMed
21.
Zurück zum Zitat Bischoff-Ferrari H, Willett W, Wong J, et al. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005;293:2257–2263.CrossRefPubMed Bischoff-Ferrari H, Willett W, Wong J, et al. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005;293:2257–2263.CrossRefPubMed
22.
Zurück zum Zitat Hanley D, Cranney A, Jones G, et al. Vitamin D in adult health and disease: a review and guideline statement from Osteoporosis Canada. CMAJ. 2010;182:E610–E618.CrossRefPubMedPubMedCentral Hanley D, Cranney A, Jones G, et al. Vitamin D in adult health and disease: a review and guideline statement from Osteoporosis Canada. CMAJ. 2010;182:E610–E618.CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Schwalfenberg G, Genuis S, Hiltz M. Addressing vitamin D deficiency in Canada: a public health innovation whose time has come. Public Health. 2010;124:350–359.CrossRefPubMed Schwalfenberg G, Genuis S, Hiltz M. Addressing vitamin D deficiency in Canada: a public health innovation whose time has come. Public Health. 2010;124:350–359.CrossRefPubMed
24.
Zurück zum Zitat Travis S, Feagan BG, Rutgeerts P, et al. The future of inflammatory bowel disease management: combining progress in trial design with advances in targeted therapy. J Crohns Colitis. 2012;6:S250–S259.CrossRefPubMed Travis S, Feagan BG, Rutgeerts P, et al. The future of inflammatory bowel disease management: combining progress in trial design with advances in targeted therapy. J Crohns Colitis. 2012;6:S250–S259.CrossRefPubMed
Metadaten
Titel
Impact of High-Dose Vitamin D3 Supplementation in Patients with Crohn’s Disease in Remission: A Pilot Randomized Double-Blind Controlled Study
verfasst von
Neeraj Narula
Mohan Cooray
Rebecca Anglin
Zack Muqtadir
Alisha Narula
John K. Marshall
Publikationsdatum
14.12.2016
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 2/2017
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-016-4396-7

Weitere Artikel der Ausgabe 2/2017

Digestive Diseases and Sciences 2/2017 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.