Vitamin D increase provided modest benefits for SLE patients

Patients with systemic lupus erythematosus who increased their vitamin D levels experienced small reductions in their odds for a high disease activity score and proteinuria in a recent study.

“Vitamin D has modest benefits on disease activity and proteinuria, with no added benefit after achieving a level of 40 ng/mL,” researcher Michelle Petri, MD, MPH, professor of medicine and director of the Lupus Center, Johns Hopkins University School of Medicine, told Healio.com.

Michelle Petri

Researchers evaluated 1,006 patients with systemic lupus erythematosus (SLE; mean age, 49.6 years; 91% women) for 128 weeks. Fifty-thousand units of vitamin D₂ weekly, plus 200 units calcium/D₃ twice daily, were used to supplement SLE patients with 25-hydroxy (OH) vitamin D levels less than 40 ng/mL. The association between vitamin D levels and disease activity was estimated through longitudinal regression models.

A 20-unit increase in 25-OH vitamin D was associated with a decrease in mean SELENA-SLEDAI by 0.22 (95% CI, –0.41 to –0.02). The odds of having a SELENA-SLEDAI greater than 4 showed a 21% decrease (95% CI, 1%-37%). There was a 2% decrease in mean urine protein-to-creatinine ratio (95% CI, –0.03 to –0.01), which corresponded to a 15% decrease in the odds of having a ratio of 0.5 or greater (95% CI, 2%-27%).

“Though these associations were statistically significant, the clinical importance is relatively modest,” the researchers concluded. “Longer follow-up of our cohort, to determine if higher 25-OH vitamin D levels lead to standard clinical improvement in disease activity, is under way.”

“A very large number of SLE patients were followed over time, so this is the definitive study in SLE,” Petri said. “The previous studies, which were mostly cross-sectional, disagreed on whether vitamin D had a benefit on disease activity in SLE.”

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Source: Petri M. Arthritis Rheum. 2013;doi:10.1002/art.37953.