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ACR Special Report: Chicago, IL 2011

Vitamin D: Intriguing Data

They’ve been calling vitamin D the miracle vitamin for years, implicating low levels of the so-called “sunshine vitamin” in everything from heart disease to autoimmune conditions like multiple sclerosis and, yes, lupus. What is less clear, however, is if supplementing with vitamin D in people with low blood levels has any effect on lupus disease progression or its symptoms. Although the research is still in its infancy, it is providing some intriguing clues. Here’s what we learned at this year’s meeting:

  • Twenty people with low-to-moderate lupus disease activity and vitamin D deficiency received 100,000 IU of vitamin D a week for 4 weeks, then 100,000 a month for 6 months.xi All demonstrated dramatic improvements in their blood levels of vitamin D levels with no safety issues or negative side effects. Perhaps most important is that levels of aberrant T cells declined after 2 months of supplementation, as did levels of 2 inflammatory cytokines and anti-DNA autoantibodies. In addition, the participants demonstrated reduced B-cell activation.

“These represent very preliminary results,” said lead researcher Benjamin Terrier, MD, of the Internal Medicine Department of the Pitié-Salpétrière Hospital in Paris, France, during a press conference. Given the absence of a control group, he said, he couldn’t even say for sure that the immunologic effects were related to the vitamin D. However, he also called the results “encouraging” because they demonstrated the safety of such high doses of vitamin D in people with lupus.

Next step: Randomized clinical trials

  • ALR grantee Michelle Petri, MD, of Johns Hopkins University School of Medicine in Baltimore, presented results from another study of vitamin D in lupus patients. She and her colleagues evaluated vitamin D levels in 922 patients between July 2009 and December 2010. They found that younger age, higher cholesterol levels, higher systolic (the top number) blood pressure, a higher urine protein/creatinine ratio (a sign of renal problems), and obesity were associated with low vitamin D levels. In addition, patients with low vitamin D levels were more likely to have lupus-related kidney and cardiovascular damage. However, supplementing with vitamin D had no effect on patients’ symptoms, although it did lead to a significant reduction in their urine protein/creatinine ratio and an increase in complement C4 and C4, both signs of disease improvement. There was no effect on anti-DNA autoantibodies, however. Yet, Dr. Petri noted, there was a trend towards a reduction in the amount of prednisone patient required to control their symptoms. While the reduction was not statistically significant, it “is suggestive” that increasing vitamin D levels can impact disease severity.

Key point: Supplementing with vitamin D may provide some benefits for people with lupus who have low blood levels of the vitamin, but large, randomized clinical trials are necessary.

More information about lupus and treatment advances can be found by visiting www.lupusresearch.org.

The Alliance for Lupus Research Special Report on the 2011 American College of Rheumatology Meeting was made possible in part by generous support from Genentech.

©2011 Alliance for Lupus Research. All Rights Reserved.

Contents herein may not be reproduced, republished or distributed without the prior written permission of the Alliance for Lupus Research. To request permission to reproduce, republish or distribute any part of this report, contact us at 212-218-2840 or email info@lupusresearch.org.

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