Therapeutic and maintenance regimens of vitamin D3 supplementation in healthy adults: A systematic review

Hassan, Adla B; Hozayen, Reham; Alotaibi, Raed Aqshan; Tayem, Yasin

doi:10.14715/cmb/2018.64.14.2

Cited by 10 publications

(8 citation statements)

References 46 publications

(46 reference statements)

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“…Furthermore, the massive monthly or bi-monthly oral dose was more convenient and was the best dose to maintain the levels relatively close to the previously optimized therapeutic levels in almost all patients year-round. Our results are consistent with a recent study that showed 50.000 IU vitamin D 3 bimonthly is required to maintain longterm sufficient 25(OH)D levels (Hassan, Hozayen, Alotaibi, & Tayem, 2018;Khawaja et al, 2017). Our results regarding the effectiveness of the larger bolus maintenance dose of 50.000 IU bimonthly in maintaining optimal serum 25(OH) D concentrations and even in some patients to ≥ 75 nmol/l, was inconsistent with other study that showed a higher monthly oral dose of 100.000 IU vitamin D for six months was more effective than a monthly dose of 50.000 IU in achieving serum-25(OH) D≥75 nmol/l (Mazahery, Stonehouse, & von Hurst, 2015).…”

Section: Discussionsupporting

confidence: 93%

Dosing Strategy of Vitamin D therapy in Patients with Rheumatic Diseases in Bahrain

Hassan

Naga²,

Mustafa

et al. 2019

AGJSR

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Purpose: The assessment of vitamin D status (25(OH)D) and dosing strategies for patients with rheumatic diseases (RDs) in Bahrain are lacking. The current study aimed to determine serum 25(OH)D levels at baseline and after Cholecalciferol (Vitamin D3) therapy and to assess the changes in serum levels in response to three different regimens in adult patients with RDs in Bahrain. Methods: Data was collected retrospectively from 158 patients with RDs, during a period 20132019- at King Abdullah Medical City. The mean age of the patients was 45 years (range 18 - 83 years). Two third (66.46%, 105) of them were females. The controls were adult sex- and age-matched healthy volunteers. All patients were investigated for vitamin D status during their first visits. Three regimens of Vitamin D3 therapy were assessed: Regimen1. A single parenteral dose of 600.000 IU. Regimen2. An oral dose of 50.000 IU weekly for 12 weeks, Regimen3. Maintenance oral dose whenever a patient achieved an optimal level. Results: The patients had lower serum levels of vitamin D3 compared to controls (P-Value=0.001; 95%C.I. (3.870, 15.599)). There was a statistically significant increase in mean serum levels of Vitamin D3 in Parenteral compared to Oral therapy (P-value<0.0005). In the patient group, vitamin D3 therapy leads to a statistically significant increase in its baseline level (P-value<0.0005), but the reduction in vitamin D3 from the therapeutic levels during maintenance was statistically not significant (P-value=0.177). Conclusion: The significant increase in serum 25(OH)D levels from baseline in response to Vitamin D3 regimens was best achieved with single parenteral therapy of 600.000 IU. Maintenance therapy to maintain optimal level year-round is a must, and the best dose was 50.000 IU orally every 24- weeks.

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Section: Discussionsupporting

confidence: 93%

Dosing Strategy of Vitamin D therapy in Patients with Rheumatic Diseases in Bahrain

Hassan

Naga²,

Mustafa

et al. 2019

AGJSR

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“…Additionally, it was found that the best regimen to supplement vitamin D in healthy adults consists of an initial large bolus dose of 600 000 IU monthly by intramuscular injections or a monthly oral dose of 200 000 IU or a weekly oral dose of 50 000 IU for 8 weeks, followed by a maintenance dose of 50 000 IU monthly or bimonthly. 51 The precise pathophysiology of IBS is not well-understood. It is hypothesized to involve interactions at the level of the gut microbiome, alterations in intestinal permeability, gut immunity, visceral sensation, and brain-gut interactions.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, to avoid adverse effects of vitamin D, the recommended dietary allowance of vitamin D is approximately 600 IU/day, with an upper limit of 4000 IU/day. Additionally, it was found that the best regimen to supplement vitamin D in healthy adults consists of an initial large bolus dose of 600 000 IU monthly by intramuscular injections or a monthly oral dose of 200 000 IU or a weekly oral dose of 50 000 IU for 8 weeks, followed by a maintenance dose of 50 000 IU monthly or bimonthly 51 …”

Section: Discussionmentioning

confidence: 99%

Vitamin D supplementation for irritable bowel syndrome: A systematic review and meta‐analysis

Chong

Yaow

Loh

et al. 2022

J of Gastro and Hepatol

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Background and Aim Irritable bowel syndrome (IBS) is a prevalent and complex gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits. Observational studies have suggested a relationship between serum vitamin D levels and IBS symptoms. This systematic review and meta‐analysis aimed to investigate the clinical effects of vitamin D supplementation on IBS symptom severity and quality of life (QoL) measures. Methods Medline, Embase, Scopus, Web of Science, and The Cochrane Library databases were systematically searched. Data abstraction and quality assessment were conducted by four authors independently, and discrepancies were resolved through consensus from the senior author. Continuous data were pooled with standardized mean difference (SMD) using the DerSimonian and Laird's random‐effects model. Sensitivity analysis by risk of bias and potentially “predatory” publication were performed as well. Results A total of 685 patients across eight studies were included in the meta‐analysis. Vitamin D supplementation significantly improved IBS symptom severity scale scores, with a SMD of −0.77 (95% confidence interval [CI] −1.47 to −0.07, P = 0.04, I2 = 91%). Improvements in IBS‐QoL scores were also observed, albeit not statistically significant (SMD 0.54; 95% CI −0.34 to 1.41, P = 0.15, I2 = 87%). However, small sample sizes, a relatively young study population, limited ethnicities, and varied vitamin D dosing strategies across the studies were notable limitations. Conclusions Vitamin D supplementation could be part of our clinical armamentarium when managing IBS patients due to the potential efficacy and good safety profile. Further randomized, controlled trials are required to confirm the therapeutic effects.

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“…• Лечение дефицита витамина D рекомендуется препаратом колекальциферола** при установленном его дефиците (Таблица 8) и назначается курсом в лечебных дозах с последующим переводом на профилактическую терапию (Таблица 9) [237][238][239][240][241][242][243][244].…”

Section: витамин D и кальцийunclassified

“…Другой объединенный анализ 68 500 пациентов, получавших только колекальциферол**, не показал снижения риска переломов. Но комбинация препаратов кальция с колекальциферолом** снижала риск всех переломов на 12% (p = 0,025), переломов бедренной кости -на 26% (p = 0,005) [239].…”

Section: уровень убедительности рекомендаций а (уровень достоверности доказательств -1)unclassified

Federal clinical guidelines for diagnosis, treatment and prevention of osteoporosis

Belaya

Belova²,

Biryukova

et al. 2021

Osteopor Bone Dis

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Due to continuous aging of population and increase in the number of elderly people, osteoporosis became socially significant disease leading to disability, increasing mortality and thereby putting an additional burden on the public healthcare system.Screening to identify groups with a high probability of fracture is recommended using the FRAX® Tool for all postmenopausal women and men over 50 years old (А1). In the presense of major pathological fractures (hip, spine, multiple fractures) it is recommended to diagnose osteoporosis and prescribe treatment regardless of the results of spine and hip double X-ray absorptiometry (DXA) or FRAX® (B2).It is recommended to evaluate C-terminal telopeptide when prescribing antiresorptive therapy and procollagen type 1 N-terminal propeptide (P1NP) when prescribing anabolic therapy to patients receiving osteoporosis treatment at baseline and 3 months after the start of therapy in order to assess the effectiveness of treatment early and adherence to the therapy (А2). It is recommended to diagnose osteoporosis and prescribe treatment to patients with high individual 10-year probability of major pathological fractures (FRAX®) regardless of the results of spine and hip DXA (В3).It is recommended to diagnose osteoporosis and prescribe treatment with a decrease in BMD, measured by DXA, by 2.5 or more T-score standard deviations in femoral neck, and/or in total hip, and/or in lumbar vertebrae, in postmenopausal women and men over 50 years old (А2).It is recommended to prescribe bisphosphonates, denosumab or teriparatide to prevent pathological fractures and increase BMD in patients with postmenopausal osteoporosis, osteoporosis in men, glucocorticoid-induced osteoporosis (А2). When the clinical effect of therapy in osteoporotic patients without pathological fractures is achieved (BMD T-score > -2.0 SD in femoral neck and absence of new fractures), it is recommended to interrupt bisphosphonates therapy for 1-2 years with subsequent follow-up (B2). In patients with vertebral fractures, hip fractures or multiple fractures, it is recommended to continue ceaseless long-term treatment of osteoporosis (В3).All drugs for the treatment of osteoporosis are recommended to be prescribed in combination with calcium and cholecalciferol (А2). In order to reduce the risk of recurrent fractures by prescribing osteoporosis therapy timely and maintaining long-term follow-up of patients over 50 years old with pathological fractures, it is recommended to create Fracture Liaison Services (В2).

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Therapeutic and maintenance regimens of vitamin D3 supplementation in healthy adults: A systematic review

Cited by 10 publications

References 46 publications

Dosing Strategy of Vitamin D therapy in Patients with Rheumatic Diseases in Bahrain

Dosing Strategy of Vitamin D therapy in Patients with Rheumatic Diseases in Bahrain

Vitamin D supplementation for irritable bowel syndrome: A systematic review and meta‐analysis

Federal clinical guidelines for diagnosis, treatment and prevention of osteoporosis

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