Supplementation of 1,25 dihydroxy vitamin D3 in patients with treatment naive early rheumatoid arthritis: A randomised controlled trial
International Journal of Rheumatic Diseases,  Clinical Article

GOPINATH K et al. – Supplementation of 500 IU of 1,25 dihydroxy vitamin D3 daily to previously DMARD-naïve patients with early RA along with triple DMARD therapy results in a significantly higher pain relief at the end of 3 months. The number needed to treat for this additional pain relief was 5. The prevalence of vitamin D deficiency in the study population was 68.1%.

Methods

  • An open-labeled randomized trial comparing triple disease-modifying anti-rheumatic drug (DMARD) therapy and 500 IU 1,25 dihydroxy vitamin D3 + calcium combination versus triple DMARD and calcium alone
  • The primary outcome was time to pain relief by patients’ visual analogue scale (VAS)
  • Changes in VAS after first achievement of pain relief and after 3 months were noted
  • 25 hydroxy-vitamin D levels were correlated with disease activity scor (DAS-28), adjusting for sun exposure
  • Comparisons between groups were done by Mann–Whitney test and independent samples test

Results
  • Patients on vitamin D group (n = 59) had higher pain relief than the control group (n = 62) (50%vs. 30%, P = 0.006)
  • No significant difference in the time taken for initial pain relief between 2 groups
  • Occurrence of hypovitaminosis D in RA patients (68.1%) is comparable to published normal Indian prevalence
  • No correlation between 25 hydroxy vitamin D levels and disease activity

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