The Effect of Vitamin D Supplementation on Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis

Guan, Yu; Yang, Hao; Guan, Yun; Bu, Huaien; Wang, Hongwu

doi:10.3389/fmed.2020.596007

Cited by 38 publications

(31 citation statements)

References 39 publications

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“…However, improvement was not observed in other parameters such as VAS (Patient Global Pain Score), SJC (Swollen Joint Count), or CRP. Notably, in a subgroup analysis, a significantly improved VAS score was observed with vitamin D supplementation of more than 50,000 IU/week, for more than 12 weeks [ 40 ]. The pharmacological mechanism of 1,25D in RA has also been investigated.…”

Section: Vitamin D and Autoimmune Diseasementioning

confidence: 99%

The Effects of Vitamin D on Immune System and Inflammatory Diseases

2021

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Immune cells, including dendritic cells, macrophages, and T and B cells, express the vitamin D receptor and 1α-hydroxylase. In vitro studies have shown that 1,25-dihydroxyvitamin D, the active form of vitamin D, has an anti-inflammatory effect. Recent epidemiological evidence has indicated a significant association between vitamin D deficiency and an increased incidence, or aggravation, of infectious diseases and inflammatory autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, and multiple sclerosis. However, the impact of vitamin D on treatment and prevention, particularly in infectious diseases such as the 2019 coronavirus disease (COVID-19), remains controversial. Here, we review recent evidence associated with the relationship between vitamin D and inflammatory diseases and describe the underlying immunomodulatory effect of vitamin D.

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Section: Vitamin D and Autoimmune Diseasementioning

confidence: 99%

The Effects of Vitamin D on Immune System and Inflammatory Diseases

2021

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“…Although the observed association between vitamin D status and RA incidence and severity, like in other diseases, could be partly explained by confounders, the results from clinical trials have suggested that giving vitamin D to patients with RA may help mitigate the disease activity. In a meta-analysis of six studies including 438 RA patients, vitamin D supplementation resulted in a significant improvement in the DAS28 (weighted mean difference (WMD) −0.41, 95%CI: −0.59–−0.23), erythrocyte sedimentation rate (WMD −3.40, 95%CI: −6.62–−0.18), and tender joint count (WMD −1.44, 95%CI: −2.74–−0.14), but not in pain visual analog scale [ 72 ]. It was also shown in another meta-analysis of two randomized studies that vitamin D supplementation resulted in an insignificant reduction in RA flares, defined by a DAS28 of >3.2 (risk difference −0.10, 95% CI: −0.21–0.00), although a high risk of bias was noted in one of the studies due to the open-label design [ 73 , 74 ].…”

Section: Evidence On Vitamin D For Prevention and Treatment Of Rheumatic Diseasesmentioning

confidence: 99%

Vitamin D and Rheumatic Diseases: A Review of Clinical Evidence

Charoenngam

2021

IJMS

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Vitamin D plays an important role in maintaining a healthy mineralized skeleton. It is also considered an immunomodulatory agent that regulates innate and adaptive immune systems. The aim of this narrative review is to provide general concepts of vitamin D for the skeletal and immune health, and to summarize the mechanistic, epidemiological, and clinical evidence on the relationship between vitamin D and rheumatic diseases. Multiple observational studies have demonstrated the association between a low level of serum 25-hydroxyvitamin D [25(OH)D] and the presence and severity of several rheumatic diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), spondyloarthropathies, and osteoarthritis (OA). Nevertheless, the specific benefits of vitamin D supplements for the treatment and prevention of rheumatic diseases are less accepted as the results from randomized clinical trials are inconsistent, although some conceivable benefits of vitamin D for the improvement of disease activity of RA, SLE, and OA have been demonstrated in meta-analyses. It is also possible that some individuals might benefit from vitamin D differently than others, as inter-individual difference in responsiveness to vitamin D supplementation has been observed in genomic studies. Although the optimal level of serum 25(OH)D is still debatable, it is advisable it is advisable that patients with rheumatic diseases should maintain a serum 25(OH)D level of at least 30 ng/mL (75 nmol/L) to prevent osteomalacia, secondary osteoporosis, and fracture, and possibly 40–60 ng/mL (100–150 nmol/L) to achieve maximal benefit from vitamin D for immune health and overall health.

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“…2). The importance of vitamin D supplementation has been debated in RA, and a recent meta-analysis showed that doses of vitamin D ≥50,000 IU seem to improve the quality of life and diminish the clinical disease activity index 40 . Finally, higher scores of RAQoL correlated with a greater functional disability, anxiety, and depression (Figs.…”

Section: Discussionmentioning

confidence: 98%

Suicide Risk in Rheumatoid Arthritis Patients is Associated With Suboptimal Vitamin D Levels

Espinoza¹,

Chavarria-Ávila

Pizano-Martínez

et al. 2022

J Clin Rheumatol

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Background/ObjectiveRheumatoid arthritis (RA) patients might experience anxiety and depressive symptoms. Deficient vitamin D levels may be a trigger for these conditions. The aim of this study was to determine the frequency of depression, anxiety symptoms, and suicidal risk or ideation in patients with RA associated with vitamin D serum levels.MethodsIn this cross-sectional study, we recruited RA patients older than 18 years, classified into 3 groups according to serum vitamin D levels: sufficient, ≥30 ng/mL; insufficient, 20–29 ng/mL; and deficient, <20 ng/mL. Based on the self-reported Plutchik and the Hospital Anxiety and Depression Scale, we evaluated the association of suicidal risk, depression, and anxiety with the vitamin D levels in RA and the Rheumatoid Arthritis Quality-of-Life Questionnaire.ResultsWe studied 72 patients with RA between January and October 2019. We found an inverse correlation between Plutchik score and suicidal risk with inadequate vitamin D levels, but not with the Hospital Anxiety and Depression Scale. Suicidal ideation was associated with a higher score on the Rheumatoid Arthritis Quality-of-Life Questionnaire.ConclusionsDespite the high prevalence of depressive and anxiety symptoms in RA patients, a Plutchik low correlation coefficient with inadequate serum levels of vitamin D was found. However, in the analysis of covariance, we were able to find that vitamin D levels remain associated with a reduction of suicide ideation. Further studies are needed to identify a risk profile for early psychological interventions to improve the quality of life in RA patients.

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The Effect of Vitamin D Supplementation on Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis

Cited by 38 publications

References 39 publications

The Effects of Vitamin D on Immune System and Inflammatory Diseases

The Effects of Vitamin D on Immune System and Inflammatory Diseases

Vitamin D and Rheumatic Diseases: A Review of Clinical Evidence

Suicide Risk in Rheumatoid Arthritis Patients is Associated With Suboptimal Vitamin D Levels

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