Vitamin‐D supplementation as an adjunct to standard treatment of asthma in children: A randomized controlled trial (ViDASTA Trial)

Abstract

Objective: To determine the role of vitamin D supplementation as an adjunct to standard treatment in childhood asthma.Study Design: In this placebo-controlled, blinded, randomized controlled trial, we enrolled 60 children aged 6 to 11 years with moderate persistent asthma and randomly assigned them into intervention (2000 IU per day of vitamin D) and placebo groups (n = 30 each). The primary outcome was asthma control as assessed by the childhood asthma control test (C-ACT) scores at 12 weeks post-randomization. The secondary outcomes were improvement in the forced expiration in 1 s (FEV 1 ), fractional exhaled nitric oxide (FeNO), asthma exacerbations, use of systemic steroids, number of emergency visits, post-intervention vitamin D levels, and adverse outcomes. We analyzed by intention to treat.Results: There was no significant difference between the C-ACT score in the two groups (median [first-third quartile] scores were 25 [24][25][26] in both groups, p = 0.7).Also, there was no significant difference between the two groups in terms of the FEV 1 , FeNO, number of exacerbations, emergency visits, hospital admissions, and adverse outcomes. However, the post-intervention vitamin D levels (ng/ml) were significantly higher in the intervention group (35.5 vs. 18.8; p < 0.001). As compared to the baseline, both the groups showed better asthma control at 12 weeks postintervention, irrespective of the type of intervention. Conclusion:Vitamin-D supplementation as an adjunct to standard treatment does not improve asthma control in children.

Vitamin D supplementation in childhood asthma: a systematic review and meta-analysis of randomised controlled trials

“…The primary outcome data are presented in figure 2 . Nine trials reported data on corticosteroid use [ 9 , 15 , 16 , 21 , 25 , 26 , 31 , 32 , 36 ]. Seven trials (654 participants) compared the requirement of rescue systemic steroids in an asthma attack [ 14 – 16 , 21 , 25 , 26 , 32 ].…”

The Effect of Vitamin D Supplementation in Children With Asthma: A Meta-Analysis

“…After reading the full texts of these studies, eight RCTs involving 738 children (376 children took vitamin D and 362 took placebos) were included in our meta-analysis (Figure 1) (16,17,(20)(21)(22)(23)(24)(25). Among the 8 RCTs, seven studies were considered to be high-quality [six had scores of 5 points (17,(21)(22)(23)(24)(25) and one had a score of 4 points (20) on the Jadad scale], and one study ( 16) was considered to be mediumquality (3 points on the Jadad scale) (Supplementary Table S3). The geographical distribution of studies was relatively wide, with four studies in Asia (17,20,21,25) and four in North America (16,(22)(23)(24).…”

“…Among the 8 RCTs, seven studies were considered to be high-quality [six had scores of 5 points (17,(21)(22)(23)(24)(25) and one had a score of 4 points (20) on the Jadad scale], and one study ( 16) was considered to be mediumquality (3 points on the Jadad scale) (Supplementary Table S3). The geographical distribution of studies was relatively wide, with four studies in Asia (17,20,21,25) and four in North America (16,(22)(23)(24). More details on the included RCTs, including baseline characteristics and main outcome indicators, are shown in Table 1.…”

Vitamina D y alergia respiratoria: estado del arte

“…65 En contraparte, existen investigaciones en las que no se reporta mejoría en el control y no se han evidenciado diferencias significativas en la función pulmonar, la fracción exhalada de óxido nítrico (FeNO), la reducción en las visitas a los servicios de urgencias e ingresos hospitalarios. 46,49,66,67,68,69,70 El estudio VDKA (Vitamina D para Prevenir Exacerbaciones Asmáticas) mostró que la suplementación con colecalciferol a una dosis de 4000 UI diarias en pacientes pediátricos, con deficiencia e insuficiencia de 25-OH-D, no modificó la presencia de crisis en relación con el grupo placebo. Otros estudios apoyan esta evidencia, asegurando que no existe un impacto en la reducción de estas en población pediátrica, pero sí en adultos.…”