SLE patients may benefit from vitamin D supplementation, study finds

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Patients who took the supplements had improvements, although they did not become noticeable until the patients took the supplements for a year.

Vitamin D supplementation appears to lead to improved disease activity and fatigue in patients with systemic lupus erythematosus (SLE), according to a new study.

The study suggests that vitamin D may be an inexpensive method of improving outcomes for some patients with SLE, although the report is based on a small sample size and requires further study, according to the authors. The report was published in the journal BMC Rheumatology.

Corresponding author Rosalie Magro, MD, University of Malta, and colleagues explained that while vitamin D deficiency is common in the general population, the problem is even more pronounced in patients with SLE. The reasons for this are unknown, although Magro and his colleagues have said that patients with SLE may simply spend less time in the sun than the general population.

Recent evidence has identified the presence of vitamin D receptors (VDRs) in innate and adaptive immune systems, raising the possibility that vitamin D deficiency may play a more important role in diseases like SLE than it is. never thought so before.

Investigators recruited a cohort of 31 patients with SLE who lacked adequate levels of vitamin D. Thirteen of the patients were classified as vitamin D deficient (serum 25-hydroxyvitamin D

The patients were put on a vitamin D3 supplementation regimen based on their baseline condition. Vitamin D deficient patients received 8,000 IU of vitamin D3 per day for 8 weeks. Those in the insufficient category received 4 weeks of treatment at the same dose. After initial treatment, patients received a daily maintenance dose of 2000 IU.

Investigators performed baseline, 6-month, and 12-month assessments using interviews, questionnaires, and blood tests. They also evaluated the signature genes for interferon in the patients’ ribonucleic acid.

Study patients taking disease-modifying therapies were not allowed to increase their dose or start new therapies during the study, to ensure they did not skew the results.

By 6 months, 83.9% of patients had achieved sufficient vitamin D levels (defined as serum vitamin D ≥ 30 ng / mL. However, by 12 months, the vitamin D adequacy rate had fallen to 35.5 The researchers said it could be due to a lack of adherence to study protocols, based on the number of boxes of vitamin D pills patients collected from patients’ pharmacies. The data suggests that 64.5% of patients did not collect enough tablets to meet the recommended dose.

Still, the researchers noted an improvement in overall scores on the SLE-2K Disease Activity Index scale, as well as an improvement in fatigue severity scale scores at 12 months. They also found a decrease in anti-double-stranded deoxyribonucleic acid, a sign that the severity of the disease may improve. Mean interferon signature gene expression scores changed at 6 months, but did not reach statistical significance, the authors said.

Magro and colleagues noted that although there were much higher levels of vitamin D sufficiency at 6 months, improvements in disease activity and fatigue did not come until the assessment at 12. months, suggesting that long-term supplementation is needed to achieve significant results.

The authors concluded that their study supports the idea of ​​screening for vitamin D in patients with SLE, to identify those who might benefit from supplementation.

“Correcting vitamin D deficiency in patients with SLE has potential benefits in terms of suppressing expression of genes in the interferon pathway, consequently leading to improved activity of the SLE disease, ”they wrote.

Reference:

Magro R, Saliba C, Camilleri L, Scerri C and Borg AA. Vitamin D supplementation in systemic lupus erythematosus: relationship to disease activity, fatigue, and expression of the interferon signature gene. BMC Rhumatol. Published online December 3, 2021. doi: 10.1186 / s41927-021-00223-1

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