Vitamin D does not prevent Crohn’s recurrence after resection

SAN DIEGO — High-dose vitamin D treatment did not help reduce incidence of postoperative recurrence in patients with Crohn’s disease, according to data presented at Digestive Disease Week.

“Vitamin D deficiency is common in Crohn’s disease and [vitamin D] has potent anti-inflammatory effects,” Marjolijn Duijvestein, PhD, of Amsterdam UMC in The Netherlands, said in her presentation. “When you add vitamin D to T cells, you actually see a decrease of pro-inflammatory cytokines and an increase of anti-inflammatory cytokines.”

Researchers conducted a placebo-controlled trial comprising 143 patients with CD to assess the potential anti-inflammatory effects of vitamin D. Patients were randomly assigned to receive either 25,000 International Units of vitamin D3 (n = 72) or placebo (n = 71) weekly for 6 months after their first or second ileocolonic resection.

Endoscopic recurrence at week 26 based on a modified Rutgeerts score of i2b served as the primary endpoint. Researchers also assessed clinical recurrence (defined as a CD activity index score 220), quality of life and safety, as well as differential outcomes by baseline vitamin D.

While serum vitamin D levels increased in the vitamin D group and remained unchanged in the placebo group, investigators found no difference in the incidence or severity of endoscopic recurrence at week 26 between the two groups. Cumulative clinical recurrence rates at week 26 were also comparable.

Duijvestein said that their findings show that vitamin D deficiency in patients with recurrent CD might be a result of disease activity and not a causal explanation for the pathophysiology of the disease itself.

“Weekly 25,000 IU of vitamin D almost doubled the serum levels of vitamin D in [CD] patients,” she said. “However, there was no difference in the endoscopic nor clinical recurrence at week 26 between vitamin D and placebo.” – by Alex Young

Reference:

Duijvestein M, et al. Abstract 144. Presented at: Digestive Disease Week; May 18-21, 2019; San Diego.

Disclosures: Duijvestein reports financial ties to Echo Pharma, Dr. Falk Pharma, Janssen, Merck, Pfizer, Robarts Clinical Trials, Takeda and Tillots. Please see the meeting disclosure index for all other authors’ relevant financial disclosures.