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High Doses of Vitamin D to Reduce Exacerbations in Chronic Obstructive Pulmonary Disease
Annals of Internal Medicine, 01/20/2012
Clinical Article
Lehouck A et al. – High–dose vitamin D supplementation in a sample of patients with chronic obstructive pulmonary disease (COPD) did not reduce the incidence of exacerbations. In participants with severe vitamin D deficiency at baseline, supplementation may reduce exacerbations.
Methods- Randomized, single–center, double–blind, placebo–controlled trial.
- University Hospitals Leuven, Leuven, Belgium.
- 182 patients with moderate to very severe COPD and a history of recent exacerbations.
- 100 000 IU of vitamin D supplementation or placebo every 4 weeks for 1 year.
- The primary outcome was time to first exacerbation.
- Secondary outcomes were exacerbation rate, time to first hospitalization, time to second exacerbation, FEV1, quality of life, and death.
- Mean serum 25–(OH)D levels increased significantly in the vitamin D group compared with the placebo group (mean between–group difference, 30 ng/mL [95% CI, 27 to 33 ng/mL]; P < 0.001).
- The median time to first exacerbation did not significantly differ between the groups (hazard ratio, 1.1 [CI, 0.82 to 1.56]; P = 0.41), nor did exacerbation rates, FEV1, hospitalization, quality of life, and death.
- However, a post hoc analysis in 30 participants with severe vitamin D deficiency (serum 25–[OH]D levels <10 ng/mL) at baseline showed a significant reduction in exacerbations in the vitamin D group (rate ratio, 0.57 [CI, 0.33 to 0.98]; P = 0.042).
