Effect of vitamin D supplementation on pain and physical function in patients with knee osteoarthritis (OA): an OA Trial Bank protocol for a systematic review and individual patient data (IPD) meta-analysis

Jin, Xingzhong; Antony, Benny; Wang, Xia; Persson, Monica S M; McAlindon, Timothy E.; Arden, N K; Srivastava, S.R.; Srivastava, Rajeshwar Nath; Middelkoop, Marienke van; Bierma-Zeinstra, Sita M A; Zhang, Weiya; Cicuttini, Flavia Maria; Ding, Changhai

doi:10.1136/bmjopen-2019-035302

Cited by 11 publications

(8 citation statements)

References 53 publications

(48 reference statements)

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“…To the best of our knowledge, we provide here the first quasi-experimental data of patients with musculoskeletal pain examining the effect of vitamin D supplementation in addition to physiotherapy compared to only physiotherapy intervention on the reduction of pain parameters (e.g., pain severity, affective pain interference, and physical pain interference). In line with our findings, a systematic review and meta-analysis of published randomized controlled trials suggested that vitamin D supplementation can decrease pain scores significantly ( 31 ). Another review also concluded that vitamin D may establish a safe, simple, and potentially beneficial way to reduce pain among patients with vitamin D deficiency ( 32 ).…”

Section: Discussionsupporting

confidence: 88%

Combined Effect of Vitamin D Supplementation and Physiotherapy on Reducing Pain Among Adult Patients With Musculoskeletal Disorders: A Quasi-Experimental Clinical Trial

Ali¹,

Uddin

Hossain

2021

Front. Nutr.

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Background: The prevalence of musculoskeletal disorders (MSD) and vitamin D insufficiency is high. Past research indicating vitamin D supplementation and physiotherapy are useful for the treatment of MSDs. However, to the best of our knowledge, the combined benefits of vitamin D and physiotherapy are not yet evaluated in MSD. We hypothesized that combined intervention of vitamin D supplementation and physiotherapy would be more effective in relieving the pain of MSD compared to only physiotherapy intervention.Objective: This study aimed to examine whether combined effect of vitamin D supplementation and physiotherapy was better than physiotherapy alone in reducing pain-related outcomes (e.g., pain severity, affective interference, and physical interference) in patients with MSD.Methods: A quasi-clinical experiment was conducted between May 2020 and April 2021. Vitamin D level in the blood was measured at the start of the study. Patients with vitamin D levels <20 ng/mL were assigned to the combined physiotherapy and vitamin D group. The physiotherapy group consisted of the patients with vitamin D levels more than 20 ng/mL. The Brief Pain Inventory scale was utilized to measure pain at baseline and after 12 weeks of interventions. We used the paired t-tests for unadjusted analysis. Further, a linear regression model was used to identify the combined effect of physiotherapy and vitamin D on reducing pain scores after adjusting potential confounders.Results: Combined intervention of vitamin D and physiotherapy showed significantly better results than only physiotherapy intervention in the reduction of three pain-related outcomes (p < 0.001). The multivariable analysis indicated that the combination of physiotherapy and vitamin D treatment reduced pain score by 1.126 (slope = −1.126, p = 0.035) compared to physiotherapy alone.Conclusion: Combined intervention (vitamin D with physiotherapy) had a better pain-relieving effect than physiotherapy alone. To confirm these findings, more research is needed with randomized control trials.Clinical Trial Registration: [http://ctri.nic.in/Clinicaltrials/advancesearchmain.php], identifier [CTRI/2020/04/024845].

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Section: Discussionsupporting

confidence: 88%

Combined Effect of Vitamin D Supplementation and Physiotherapy on Reducing Pain Among Adult Patients With Musculoskeletal Disorders: A Quasi-Experimental Clinical Trial

Ali¹,

Uddin

Hossain

2021

Front. Nutr.

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“…Vitamin D reduced pain and improved function in knee OA patients. While deficiency in endogenous vitamin D, reflected by low levels of circulating 25 OH vitamin D, was associated with the onset and progression of knee OA [38], maybe through an increased frequency of medial meniscus lesions [39], results of individual RCTs were inconclusive [40][41][42][43]. Their outcomes varied from a non-significant trend for symptom reduction [40][41][42] to a small but statistically significant benefit on pain and function after 12 months of administration [43].…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Efficacy of Pharmacological Treatments for Knee Osteoarthritis: A Systematic Review and a Network Meta-Analysis with a 6-Month Time Horizon

Beaudart

Lengelé

Leclercq

et al. 2020

Drugs

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Introduction Several pharmacological treatments aiming at a better symptomatic control of osteoarthritis (OA) are used in daily practice but their efficacy is often disputed. The purpose of this network meta-analysis (NMA) is to assess the efficacy on pain and function of the drugs that are most widely prescribed against knee OA. Methods Medline, Scopus, and Cochrane database of systematic reviews were searched for randomized controlled trials published up to August 2019 and assessing the efficacy of knee OA treatments using a 6-month time horizon. Pain and function changes from baseline were the primary outcomes. A Bayesian network meta-analysis was run and standardized mean differences (SMDs) with 95% credibility intervals (95% CrIs) were calculated. Results 9697 references were identified and 80 RCTs were concordant with our inclusion criteria (79 studies involving 15,609 individuals reported pain outcomes and 55 studies involving 13,655 individuals reported function outcomes). A significant decrease in pain was observed for the intra-articular (IA) combination of hyaluronic acid (HA) and triamcinolone (SMD − 0.49, 95% CrI − 0.78; − 0.19), vitamin D (SMD − 0.31, 95% CrI − 0.56; − 0.06), IA HA (SMD − 0.29, 95% CrI − 0.40; − 0.17), prescription-grade crystalline glucosamine sulfate (pCGS) (SMD − 0.29, 95% CrI − 0.58; − 0.004), and prescription-grade chondroitin sulfate (pCS) (SMD − 0.26, 95% CrI − 0.44; − 0.08). Significant improvements in physical function were found with pCGS (SMD − 0.44, 95% CrI − 0.66; − 0.21), vitamin D (SMD − 0.30, 95% CrIs − 0.49; − 0.11) and IA HA (SMD − 0.21, 95% CrIs − 0.31; − 0.11). Conclusion Six months of treatment with IA HA, pCGS, pCS, vitamin D and the combination of IA HA and triamcinolone improve pain and/or physical function in patients suffering from knee OA.

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“…Based on their analysis, the authors conclude that despite the fact vitamin D supplementation may improve pain and function in patients with knee osteoarthritis, the evidence from randomized clinical trials (RCTs) was controversial, because not all the RCTs measured the potential moderators of interest, or, not all of them were measured in the same way. Nevertheless, the results published by Jin et al can provide critical evidence to help clinicians make subgroup-specific treatment decisions in order to increase therapeutic efficacy [ 59 ].…”

Section: Vitamin D and Pain Managementmentioning

confidence: 99%

Vitamin D and Temporomandibular Disorders: What Do We Know So Far?

et al. 2021

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Background and aims. Vitamin D is synthesized in the skin with the aid of ultraviolet-B radiation, playing a variety of roles in the body. Temporomandibular disorders (TMDs) are a group of pathological conditions involving the temporomandibular joints as well as the masticatory muscles and othersurrounding tissues. In the present narrative review, we investigated the potential role of vitamin D in the etiology of temporomandibular disorders in order todetermine whether the current knowledge supports 25-hidroxyvitamin D (25-OHD) supplementation in temporomandibular disorders associated with insufficient or deficient levels of vitamin D. Methods. A literature research was performed in PubMed, Scopus, Science Direct, and Google Scholar databases, and a total of 10 articles were included for analysis. Results.Among the observational studies published to date, investigating the role for vitamin D in the etiology of TMDs, six of them suggest that there is a connection between the two aspects. In this context, patients suffering from TMD, with deficient levels of vitamin D (<30 ng/mL), are most likely to benefit from supplementation, whereas individuals with vitamin D level >50ng/mL probably have little benefit from supplementation.Conclusion.Vitamin D might be a safe, simple, and potentially beneficial way to prevent TMDs or to reduce pain; however, more randomized and placebo-controlled trials are required before any firm conclusions can be drawn.

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Effect of vitamin D supplementation on pain and physical function in patients with knee osteoarthritis (OA): an OA Trial Bank protocol for a systematic review and individual patient data (IPD) meta-analysis

Cited by 11 publications

References 53 publications

Combined Effect of Vitamin D Supplementation and Physiotherapy on Reducing Pain Among Adult Patients With Musculoskeletal Disorders: A Quasi-Experimental Clinical Trial

Combined Effect of Vitamin D Supplementation and Physiotherapy on Reducing Pain Among Adult Patients With Musculoskeletal Disorders: A Quasi-Experimental Clinical Trial

Symptomatic Efficacy of Pharmacological Treatments for Knee Osteoarthritis: A Systematic Review and a Network Meta-Analysis with a 6-Month Time Horizon

Vitamin D and Temporomandibular Disorders: What Do We Know So Far?

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