Vitamin D in ankylosing spondylitis: Review and meta-analysis

Cai, Guoqi; Wang, Li; Fan, Dazhi; Xin, Lihong; Liu, Li; Hu, Yun; Ding, Ning; Xu, Shengqian; Xia, Guo; Jin, Xingzhong; Xu, Jianhua; Zou, Yanfeng; Pan, Faming

doi:10.1016/j.cca.2014.08.040

Cited by 49 publications

(36 citation statements)

References 47 publications

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“…Moreover, most studies reported results of 25(OH)D using mean standard deviation; meanwhile, 25(OH)D is not a normally distributed variable [20]. Consequently, results from currently available meta-analyses need to be further explored [20, 29, 37]. Taken collectively, causation is not currently proven despite some evidence for increased risk of AS in subjects with vitamin D deficiency.…”

Section: Mechanistic Link Between Low Vitamin D Status and “As”mentioning

confidence: 99%

“…In addition, whether such a strategy will be beneficial in terms of important health outcomes beyond skeletal benefits is still a matter of debate. However, numerous available epidemiological studies have suggested that sufficient 25(OH)D level may be beneficial in reducing the risk of AS [20, 29, 37]. Even though this is not the guarantee for cost-effectiveness of AS prevention and treatment by vitamin D supplementation, we would suggest systematic screening of vitamin D deficiency for all AS patients and treatment with vitamin D in case of vitamin D insufficiency/deficiency or if the patient has either of the ascertained risk factors for vitamin D deficiency.…”

Section: Vitamin D Treatment For “As” Patientsmentioning

confidence: 99%

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Are Systematic Screening for Vitamin D Deficiency and Vitamin D Supplementation Currently Feasible for Ankylosing Spondylitis Patients?

Essouma

Noubiap

2017

International Journal of Inflammation

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Beyond its role in calcium and phosphorus metabolism for healthy bone mineralization, there is increasing awareness for vitamin D contribution in modulation of immune reactions. Given that ankylosing spondylitis (AS) is a chronic inflammatory disease involving excess immune/inflammatory activity and posing great therapeutic challenges, it is conceivable to claim that vitamin D treatment may be a safe and effective treatment to influence or modify the primary disease and its related comorbidities. Nevertheless, consistent body of research supporting this hypothesis is still lacking. In this paper, we examine whether systematic screening and treatment for vitamin D deficiency are feasible at present. We will review the immunomodulatory role of vitamin D and its contribution in initiation and progression of AS, as well as how they would determine the occurrence of comorbid conditions. Our conclusion is that despite the overwhelmed interest about vitamin D treatment in AS patients, systematic screening and treatment for vitamin D deficiency of all AS patients are not feasible as yet. This stresses the need for further extensive well-designed research to prove vitamin D efficacy in AS beyond bone protection. And if utility is proven, personalized treatment regimes, duration of treatment, and threshold values for vitamin D should be provided.

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Section: Mechanistic Link Between Low Vitamin D Status and “As”mentioning

confidence: 99%

Section: Vitamin D Treatment For “As” Patientsmentioning

confidence: 99%

Are Systematic Screening for Vitamin D Deficiency and Vitamin D Supplementation Currently Feasible for Ankylosing Spondylitis Patients?

Essouma

Noubiap

2017

International Journal of Inflammation

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“…Several epidemiological studies, highlighted the possible linkage between adequate serum levels of 25 hydroxyl vitamin D (25(OH)D) and the reduced risk of AS 68,71,72 . In a study of 48 AS patients has been reported a significant correlation between plasma 25(OH)D levels and erythrocyte sedimentation rate (ESR)/CRP, but did not observe any significant correlation with BASDAI 61 .…”

Section: Therapeutic Effect Of Vitamin D Supplementation In Asmentioning

confidence: 99%

Nutritional aspects and vitamin D supplementation in ankylosing spondylitis

Kalogeropoulou¹

2017

JRPMS

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“…While Vitamin D deficiency has been found to occur with greater prevalence in AS in some studies, other studies have failed to show a significant difference from controls [34–36]. In a recent study by Klingberg et al, there was no correlation with 25-OH-Vitamin D levels and BMD or vertebral fractures in patients with AS [36].…”

Section: Treatmentmentioning

confidence: 99%

Osteoporosis Management in Ankylosing Spondylitis

Hinze

Louie

2016

Curr Treat Options in Rheum

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OPINION STATEMENT Low bone mineral density (BMD) is increasingly recognized as a common comorbid condition in ankylosing spondylitis (AS). As low BMD increases fracture risk, it is important to identify and treat low BMD in patients with AS who have been shown to be at increased risk for fractures above the population normal. Since low BMD occurs early in disease, we screen during the first year of diagnosis with dual energy x-ray absorptiometry (DXA). If patients are found to have osteoporosis by T-score of less than −2.5 or if their Z-score on DXA is more than two standard deviations below the mean, we initiate therapy with bisphosphonates in males and in females who are not planning any future pregnancies. While reduction in fracture risk with bisphosphonate therapy has not been clearly defined in patients with AS, reduction in vertebral and hip fractures has been well established in primary osteoporosis and thus it is our first line treatment. If there are contraindications to the use of bisphosphonates in the treatment of low BMD, we will consider the use of denosumab. If the patient is not receiving a TNF-alpha inhibitor (TNFi) and has active disease, we also favor early initiation of TNFi due to their positive effects on BMD though the outcome on reduction in vertebral fractures remains unclear. We counsel all patients regarding the importance of adequate intake of vitamin D and calcium per the Institute of Medicine guidelines. All patients should be encouraged to participate in weight-bearing activities with a focus on core strength and gait training.

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Vitamin D in ankylosing spondylitis: Review and meta-analysis

Cited by 49 publications

References 47 publications

Are Systematic Screening for Vitamin D Deficiency and Vitamin D Supplementation Currently Feasible for Ankylosing Spondylitis Patients?

Are Systematic Screening for Vitamin D Deficiency and Vitamin D Supplementation Currently Feasible for Ankylosing Spondylitis Patients?

Nutritional aspects and vitamin D supplementation in ankylosing spondylitis

Osteoporosis Management in Ankylosing Spondylitis

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