Effect of 1,25 dihydroxy vitamin D3 supplementation on pain relief in early rheumatoid arthritis.

Authors:
Dibyendu Mukherjee
Dibyendu Mukherjee
University of Tennessee
United States
Sandeep Lahiry
Sandeep Lahiry
Institute of Post Graduate Medical Education and Research
Dwaipayan Sarathi Chakraborty
Dwaipayan Sarathi Chakraborty
Institute of Post Graduate Medical Education and Research

J Family Med Prim Care 2019 Feb;8(2):517-522

Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India.

Background: To assess effect of 1,25 dihydroxy vitamin D3 supplementation on pain relief in early rheumatoid arthritis (RA).

Materials And Methods: An open-labeled randomized trial was conducted comparing 60,000 IU 1,25 dihydroxy vitamin D3 + calcium (1000 mg/day) combination [Group A] versus calcium (1000 mg/day) only [Group B], as supplement to existing treatment regimen in early RA. Primary outcome included (i) minimum time required for onset of pain relief (Tm) assessed through patients' visual analog scale (VAS); (ii) % change in VAS score from onset of pain relief to end of 8 weeks. Secondary outcome included change in disease activity score (DAS-28).

Results: At the end of 8-weeks, Group A reported 50% higher median pain relief scores (80% vs. 30%; < 0.001) and DAS-28 scores (2.9 ± 0.6 vs. 3.1 ± 0.4; = 0.012) compared to Group B; however, Tm remained comparable (19 ± 2 vs. 20 ± 2 days; = 0.419). Occurrence of hypovitaminosis-D was lower (23.3%) compared to Indian prevalence rates and was a risk factor for developing active disease (Odds Ratio (OR) = 7.52 [95% Confidence Interval (CI) 2.67-21.16], < 0.0001). Vitamin D deficiency was significantly ( < 0.001) more common in female gender, active disease, and shorter mean disease duration. Vitamin D levels were inversely correlated to disease activity as assessed by DAS-28 ( = -0.604; < 0.001).

Conclusions: Vitamin-D deficiency is a risk factor for developing active disease in RA. Weekly supplementation of 60,000 IU of 1,25 dihydroxy vitamin D3 in early RA results in greater pain relief. The number needed to treat for this additional pain relief was 2.

Identifier: CTRI/2018/01/011532 (www.ctri.nic.in).

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Source
http://www.jfmpc.com/text.asp?2019/8/2/517/253057
Publisher Site
http://dx.doi.org/10.4103/jfmpc.jfmpc_446_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436291PMC
February 2019
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