Treatment of Vitamin D Deficiency Within a Large Integrated Health Care Delivery System

Stratton-Loeffler, Moxie J.; Lo, Joan C.; Hui, Rita L.; Coates, Ashley; Minkoff, Jerome R.; Budayr, Amer

doi:10.18553/jmcp.2012.18.7.497

Cited by 9 publications

(8 citation statements)

References 36 publications

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“…An additional 34 articles were excluded after title and abstract review because clinicians, patients, the setting, or outcomes did not meet the inclusion criteria. The remaining 38 articles were included in this review [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ]. Two gray literature documents were included within the final 38 articles.…”

Section: Resultsmentioning

confidence: 99%

Clinical Management of Low Vitamin D: A Scoping Review of Physicians’ Practices

et al. 2018

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The role of vitamin D in the prevention and treatment of non-skeletal health issues has received significant media and research attention in recent years. Costs associated with clinical management of low vitamin D (LVD) have increased exponentially. However, no clear evidence supports vitamin D screening to improve health outcomes. Authoritative bodies and professional societies do not recommend population-wide vitamin D screening in community-dwelling adults who are asymptomatic or at low risk of LVD. To assess patterns of physicians’ management of LVD in this conflicting environment, we conducted a scoping review of three electronic databases and the gray literature. Thirty-eight records met inclusion criteria and were summarized in an evidence table. Thirteen studies published between 2006 and 2015 across seven countries showed a consistent increase in vitamin D lab tests and related costs. Many vitamin D testing patterns reflected screening rather than targeted testing for individuals at high risk of vitamin D deficiency or insufficiency. Interventions aimed at managing inappropriate clinical practices related to LVD were effective in the short term. Variability and controversy were pervasive in many aspects of vitamin D management, shining a light on physicians’ practices in the face of uncertainty. Future research is needed to inform better clinical guidelines and to assess implementation practices that encourage evidence-based management of LVD in adult populations.

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Section: Resultsmentioning

confidence: 99%

Clinical Management of Low Vitamin D: A Scoping Review of Physicians’ Practices

et al. 2018

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“…There are various studies identifying baseline characteristics, such as 25OHD level, ethnicity, age, BMI and gender as predictors of treatment response . In our study, baseline characteristics (i.e.…”

Section: Discussionmentioning

confidence: 97%

Safety and effectiveness of stoss therapy in children with vitamin D deficiency

Tannous

Fiscaletti

Wood

et al. 2019

J Paediatrics Child Health

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Aim Paediatric vitamin D (25‐hydroxyvitamin D (25OHD)) deficiency can lead to nutritional rickets and extra‐skeletal complications. Compliance with daily therapy can be difficult, making high‐dose, short‐term vitamin D (stoss) therapy attractive to correct vitamin D deficiency. We compared the effectiveness and safety of standard versus stoss therapy in treating childhood 25OHD deficiency. Methods Children aged 2–16 years with 25OHD <50 nmol/L were randomised to either standard (5000 IU daily for 80 days) or stoss (100 000 IU weekly for 4 weeks) cholecalciferol. Participants underwent an evaluation of effectiveness and safety. The 25OHD level, random spot calcium: creatinine ratio (Ca:Cr) and compliance were measured at 12 weeks. Results A total of 151 children were enrolled in the study (68 standard and 83 stoss), median age 9 years (inter‐quartile range (IQR): 6–12 years). Baseline 25OHD levels were 26 nmol/L (IQR: 19–35 nmol/L) and 32 nmol/L (IQR: 24–39 nmol/L) in the standard and stoss groups, respectively. At 12 weeks, the median 25OHD level was significantly greater in the standard versus stoss group (81 vs. 67 nmol/L; P = 0.005); however, >80% of participants in both groups achieved sufficiency (25OHD > 50 nmol/L) and had normal urinary Ca:Cr, with no significant difference seen between groups. Compliance was similar in the two groups. Conclusions Compared to stoss, standard therapy achieved higher 25OHD levels at 12 weeks; however, in both groups, there was a similar proportion of participants who achieved 25OHD sufficiency, with no evidence of toxicity. Unlike other studies, simplifying the treatment regimen did not improve compliance. These results support stoss therapy as an effective and safe alternative therapy for the treatment of paediatric vitamin D deficiency.

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“…Currently, increasing prevalence and co-existence of obesity, MetS and hypovitaminosis D represent serious public health concern [66,67]. New data have considerably changed hierarchy of MetS components, with the shift of the focus from obesity and insulin resistance, firstly toward fatty liver and now toward VitD deficiency [68].…”

Section: Role Of Vitamin D In Metabolic Syndromementioning

confidence: 99%

Pathogenic and Therapeutic Role of Vitamin D in Antiphospholipid Syndrome Patients

Jelic¹,

Nikolic²,

Marisavljević³

et al. 2017

A Critical Evaluation of Vitamin D - Clinical Overview

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In this chapter, the novel findings on interrelationship between vitamin D status and two well-known prothrombotic states, antiphospholipid syndrome, particularly its thrombotic phenotype, and metabolic syndrome will be reviewed. We shall present the results obtained from patients included in Serbian National Antiphospholipid Syndrome Registry, 68 patients with primary antiphospholipid syndrome (PAPS) and 69 patients with antiphospholipid syndrome associated with certain autoimmune rheumatic disease (sAPS), as well as 50 patients with pure metabolic syndrome (MetS). These results will be analysed and compared with the novel literature data. Prevalence of MetS in APS is high, with the atherogenic dyslipidaemia as its most prevalent characteristic. Prevalence of thrombotic events was significantly higher in APS patients with coexisting MetS, compared with those without MetS. Among APS patients, prevalence of VitD deficiency was significantly higher than in patients with pure MetS.VitD level was also significantly lower in APS patients with coexisting MetS or previous thrombotic events than in those without them. Elucidating interrelationships between VitD deficiency, MetS and thrombotic events in APS patients open up the possibility of distinguishing those subjects with the particularly high cardiovascular risk and ensuing need for the strict control of modifiable risk factors and VitD supplementation.

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Treatment of Vitamin D Deficiency Within a Large Integrated Health Care Delivery System

Abstract: BACKGROUND: In the past decade, increasing attention has focused on identification and treatment of vitamin D deficiency although repletion outcomes of pharmacologic vitamin D therapy have not been examined at a population level.

Cited by 9 publications

References 36 publications

Clinical Management of Low Vitamin D: A Scoping Review of Physicians’ Practices

Clinical Management of Low Vitamin D: A Scoping Review of Physicians’ Practices

Safety and effectiveness of stoss therapy in children with vitamin D deficiency

Pathogenic and Therapeutic Role of Vitamin D in Antiphospholipid Syndrome Patients

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