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Vitamin D levels not associated with RA at baseline, therapy response
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Vitamin D levels were not associated with rheumatoid arthritis disease activity or inflammatory markers at baseline, nor were they related to therapy response or radiographic progression, according to study results.
Researchers measured the serum 25(OH) vitamin D levels of 499 patients (mean age, 49.5 years; 16.6% men) with active rheumatoid arthritis (RA) enrolled in a clinical trial of golimumab. Patients had not been treated with methotrexate or biologic therapy. Association between vitamin D levels and Disease Activity Score 28 (DAS28), van der Heijde-Sharp (vdHS) erosion scores and serum inflammatory markers were assessed through multivariable linear regression. DAS28 and ACR response were used to evaluate associations between vitamin D status and therapy response during 52 weeks.
At baseline, 48% of participants were vitamin D deficient (serum25[OH] vitamin D<20 ng/mL). Deficiency was experienced by participants who were significantly older, more likely to be female, had higher BMI and had greater low-density lipoprotein and triglyceride levels. When adjusted for age, race, sex, BMI, disease duration and glomerular filtration rate, greater DAS28 was not associated with vitamin D deficiency (B=–0.021 [95% CI, –0.22 to 0.18]). Inflammatory markers and vdHS scores were not associated with deficiency in adjusted and unadjusted models. Change in DAS28 (B=–0.024 [95% CI, –0.30 to 0.25]), proportion meeting ACR response (OR=0.82; 95% CI, 0.56-1.20) or radiographic progression (OR=0.91; 95% CI, 0.59-1.40) displayed no association with vitamin D deficiency at 52 weeks.
Study limitations included its observational design, few patients of African descent, which is a population reportedly at high risk for vitamin D deficiency. Researchers also said the cohort had high disease activity for a clinical trial, potentially resulting in a more narrow range of disease activity compared with other studies.
“Future intervention studies are needed to determine if vitamin D deficiency contributes to immune function and disease activity in RA,” the researchers concluded.
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