Adding 4000 IU of vitamin D for patients with musculoskeletal pain may lead to a faster decline of consecutive VAS scores and to a decrease in the levels of inflammatory and pain-related cytokines.

Background The current mode of therapy for many patients with musculoskeletal is unsatisfactory. Objectives To assess the impact of adding 4,000 IU of vitamin D on pain and serological parameters in patients with musculoskeletal. Methods The study was a randomized, double-blinded and placebo-controlled assessing the effect of 4,000 IU of orally given vitamin D3 (cholecalciferol) (four gel capsules of 1,000IU (SupHerb, Israel) vs. placebo on different parameters of pain. Eighty patients were enrolled and therapy was given for 3 months. Parameters were scored at three time points: prior to intervention, at week 6 and 12. The primary outcome was the percentage of patients achieving a 50% reduction on the VAS score following 3 months. We also measured serum levels of leukotriene B4 (LTB4), Interleukin 6 (IL-6), tumor necrosis factor alpha (TNFα) and Prostaglandin E2 (PGE2) by ELISA. Results The group receiving vitamin D achieved a statistically significant larger decline of their VAS measurement throughout the study compared with the placebo group (Table 1). The need for analgesic “rescue therapy” was significantly lower among the vitamin D treated group. TNFα levels decreased by 54.3% in the group treated with vitamin D and increased by 16.1% in the placebo group. PGE2 decrease of 39.2% in the group treated with vitamin D and increased by 16.1LTB4 levels decreased in both groups by 24% (p<0.05). Table 1.Results of VAS scores of patient perceived pain during the recent week at week 0, 6 and 12 Placebo treated (n=38) Vitamin D treated (n=36) Mean ± SD Mean ± SD VAS 0 63.3±22.9 72.2±20.6 VAS 6 55.2±24.7 *54.0±29.5 VAS12 54.6±28.3 *48.6±26.0 *Significant differences compared to week 0 p<0.001. Conclusions Adding 4,000 IU of vitamin D to patients with musculoskeletal pain may lead to a faster decline of consecutive VAS scores and to a decrease in the levels of inflammatory and pain related cytokines. Disclosure of Interest O. Gendelman: None declared, D. Itzhaki: None declared, H. Amital Grant/research support: Pfizer, Abvie, Consultant for: MSD DOI 10.1136/annrheumdis-2014-eular.2555