Vitamin D in Rheumatic Disease - is it Good Enough? Save
Vitamin D deficiency or insufficiency of is highly prevalent and has been often associated with inflammatory rheumatic diseases, raising the question of whether inadequate vitamin D status contributes to immune dysregulation, incipient disease, increased disease activity, or poor skeletal outcomes. A current literature review sheds light on vitamin D importance in rheumatology as well as treatment effects.
A literature search identified randomized controlled trials, observational studies, systematic reviews, and metaanalyses evaluating vitamin D status and/or supplementation in adult patients with inflammatory rheumatic diseases, including SLE, Sjogrens, RA, and SpA.
Vitamin D deficiency is highly prevalent across inflammatory rheumatic diseases and, in general, has been associated with higher disease activity, fatigue, and poorer musculoskeletal outcomes.
Experimental data support immunomodulatory effects; however, the evidence is heterogeneous. While randomized controlled trials show supplementation corrects deficiency and is safe, there are only modest improvements in disease activity and fatigue (mainly in patients with low baseline 25(OH)D levels).
Large trials and Mendelian randomization studies do not support a causal role of vitamin D in disease onset or sustained remission. Meta-analyses show small and inconsistent benefits, limited by heterogeneity in study design, dosing regimens, and populations.
Vitamin D deficiency is a common and clinically relevant finding in inflammatory rheumatic diseases. While supplementation reliably restores adequate levels and may provide modest clinical benefits in deficient patients, current evidence does not support a causal or disease-modifying role. Maintaining serum 25(OH)D ≥30 ng/mL remains advisable for skeletal health, whereas immunological benefits may require higher levels, but truly need further investigation to establish true benefits.
Continue Reading
ADD THE FIRST COMMENT
Disclosures
The author has no conflicts of interest to disclose related to this subject
If you are a health practitioner, you may Login/Register to comment.
Due to the nature of these comment forums, only health practitioners are allowed to comment at this time.