The Clinical Effect of Oral Vitamin D2 Supplementation on Psoriasis: A Double-Blind, Randomized, Placebo-Controlled Study

Abstract

Background. There are limited randomized controlled trials of oral vitamin D supplementation in psoriasis, especially in Asia, and the results are inconclusive. Objective. To investigate the clinical effect of oral vitamin D supplementation on psoriasis. Methods. Patients with psoriasis were randomized to receive vitamin D2 60,000 IU or similar-looking placebo pills once every 2 weeks for 6 months. The primary outcome was improvement of the Psoriasis Area and Severity Index (PASI) score at 3 and 6 months after treatment. Serum levels of 25(OH)D, calcium, phosphate, parathyroid hormone, and C-reactive protein and adverse events were monitored. The chi-square test, Fisher’s exact test, Student’s t-test, and Spearman’s correlation analysis were used in statistical analysis. Results. Of 50 subjects screened, 45 were eligible and randomized to the oral vitamin D2 group (n=23) or placebo group (n=22). At enrollment, the mean PASI score was 4.45, and 26.7% of patients had vitamin D deficiency. At 3 months, the oral vitamin D2 group had significantly higher PASI improvement than the placebo group (mean PASI improvement: 1.43 versus [vs.] -0.33, p-value=0.034; mean %PASI improvement: 34.21% vs. -1.85%, p-value=0.039). The mean serum 25(OH)D level was significantly higher in the oral vitamin D group than in the placebo group (27.4 vs. 22.4 ng/mL, p-value=0.029). Serum 25(OH)D concentrations were significantly inversely correlated with PASI scores at the 6-month follow-up. No major adverse event was observed overall. Conclusion. Oral vitamin D2 supplementation in patients with psoriasis increased the serum vitamin D level and significantly improved the treatment outcome without increasing adverse events. Trial Registration. This trial is registered with Thai Clinical Trials Registry TCTR20180613001.

The role of high-dose vitamin D supplementation on disease severity and lipid profile in psoriatic patients: A pilot study

“…32 Similar results were obtained in the randomised, double-blind, placebo-controlled study conducted by Disphanura et al, however, the treatment period was the same, but the vitamin D supplementation was intermittent every two weeks. 33 In contrast to the results presented in this paper, Jarrett et al found that oral vitamin D administration had no significant difference in the PASI score in patients with mild form of the disease. 34 The current study indicated the existence of a significant, but weak correlation between clinical improvements determined by change in PASI score and changes in TC and LDL-C serum level.…”

Immunologic Effects of Vitamin D on Human Health and Disease

“…Multiple clinical trials have attempted to investigate the influence of different forms of vitamin D supplementation on treatment of psoriasis, yielding varying results. A six-month study of psoriasis patients who received 60,000 IUs of vitamin D 2 once every 2 weeks not only showed significant improvement in their PASI (psoriasis area and severity index) score but also demonstrated a direct association with improvement in blood levels of 25(OH)D [ 84 ]. Another pilot study giving daily 35,000 IUs of vitamin D 3 to 9 patients with psoriasis and 16 patients with vitiligo who were vitamin D-deficient or insufficient for six months demonstrated a significant improvement in psoriasis area and severity index (PASI) in all psoriatic patients and 25–75% repigmentation in 14 of 16 vitiligo patients, without development of any complications suggestive of vitamin D toxicity including hypercalcemia, kidney stones, nephrocalcinosis, or hypercalciuria [ 85 ].…”

Oral Vitamin D Therapy in Patients with Psoriasis

“…The changes in serum concentrations of vitamin D metabolite 25(OH)D were used to monitor the side effects and were not related to the degree of improvement or worsening in psoriasis lesions. A vitamin D 2 dose higher than 40,000 IU was associated with hypercalcemia toxicity [ 40 ].…”