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Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza and Upper Respiratory Infection in Patients With Inflammatory Bowel Disease
BACKGROUND: We evaluated whether oral vitamin D supplementation during the winter and early spring reduces the incidence of influenza and upper respiratory infections in patients with inflammatory bowel disease (IBD). METHODS: A randomized, double-blind, controlled trial was conducted to compare the...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6499936/ https://www.ncbi.nlm.nih.gov/pubmed/30601999 http://dx.doi.org/10.1093/ibd/izy346 |
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author | Arihiro, Seiji Nakashima, Akio Matsuoka, Mika Suto, Satoshi Uchiyama, Kan Kato, Tomohiro Mitobe, Jimi Komoike, Nobuhiko Itagaki, Munenori Miyakawa, Yoshinari Koido, Shigeo Hokari, Atsushi Saruta, Masayuki Tajiri, Hisao Matsuura, Tomokazu Urashima, Mitsuyoshi |
author_facet | Arihiro, Seiji Nakashima, Akio Matsuoka, Mika Suto, Satoshi Uchiyama, Kan Kato, Tomohiro Mitobe, Jimi Komoike, Nobuhiko Itagaki, Munenori Miyakawa, Yoshinari Koido, Shigeo Hokari, Atsushi Saruta, Masayuki Tajiri, Hisao Matsuura, Tomokazu Urashima, Mitsuyoshi |
author_sort | Arihiro, Seiji |
collection | PubMed |
description | BACKGROUND: We evaluated whether oral vitamin D supplementation during the winter and early spring reduces the incidence of influenza and upper respiratory infections in patients with inflammatory bowel disease (IBD). METHODS: A randomized, double-blind, controlled trial was conducted to compare the effects of vitamin D supplementation (500 IU/day) and a placebo. The primary outcome was the incidence of influenza; the secondary outcome was the incidence of upper respiratory infection. Prespecified subgroup analyses were performed according to 25-hydroxyvitamin D (25-OHD) levels (low <20 ng/mL or high ≥20 ng/mL) and whether ulcerative colitis (UC) or Crohn’s disease (CD) was present. We also used the Lichtiger clinical activity index for patients with UC and the Crohn’s Disease Activity Index (CDAI) for patients with CD before and after interventions. RESULTS: We included 223 patients with IBD and randomized them into 2 groups: vitamin D supplementation (n = 108) and placebo (n = 115). The incidence of influenza did not differ between the groups. However, the incidence of upper respiratory infection was significantly lower in the vitamin D group (relative risk [RR], 0.59; 95% confidence interval (CI), 0.35–0.98; P = 0.042). This effect was enhanced in the low 25-OHD level subgroup (RR, 0.36; 95% CI, 0.14–0.90; P = 0.02). With respect to adverse events, the Lichtiger clinical activity index score was significantly worse in the vitamin D group (P = 0.002) and remained significant only in the high 25-OHD level subgroup. CONCLUSIONS: Vitamin D supplementation may have a preventative effect against upper respiratory infection in patients with IBD but may worsen the symptoms of UC. |
format | Online Article Text |
id | pubmed-6499936 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-64999362019-05-07 Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza and Upper Respiratory Infection in Patients With Inflammatory Bowel Disease Arihiro, Seiji Nakashima, Akio Matsuoka, Mika Suto, Satoshi Uchiyama, Kan Kato, Tomohiro Mitobe, Jimi Komoike, Nobuhiko Itagaki, Munenori Miyakawa, Yoshinari Koido, Shigeo Hokari, Atsushi Saruta, Masayuki Tajiri, Hisao Matsuura, Tomokazu Urashima, Mitsuyoshi Inflamm Bowel Dis Original Clinical Articles BACKGROUND: We evaluated whether oral vitamin D supplementation during the winter and early spring reduces the incidence of influenza and upper respiratory infections in patients with inflammatory bowel disease (IBD). METHODS: A randomized, double-blind, controlled trial was conducted to compare the effects of vitamin D supplementation (500 IU/day) and a placebo. The primary outcome was the incidence of influenza; the secondary outcome was the incidence of upper respiratory infection. Prespecified subgroup analyses were performed according to 25-hydroxyvitamin D (25-OHD) levels (low <20 ng/mL or high ≥20 ng/mL) and whether ulcerative colitis (UC) or Crohn’s disease (CD) was present. We also used the Lichtiger clinical activity index for patients with UC and the Crohn’s Disease Activity Index (CDAI) for patients with CD before and after interventions. RESULTS: We included 223 patients with IBD and randomized them into 2 groups: vitamin D supplementation (n = 108) and placebo (n = 115). The incidence of influenza did not differ between the groups. However, the incidence of upper respiratory infection was significantly lower in the vitamin D group (relative risk [RR], 0.59; 95% confidence interval (CI), 0.35–0.98; P = 0.042). This effect was enhanced in the low 25-OHD level subgroup (RR, 0.36; 95% CI, 0.14–0.90; P = 0.02). With respect to adverse events, the Lichtiger clinical activity index score was significantly worse in the vitamin D group (P = 0.002) and remained significant only in the high 25-OHD level subgroup. CONCLUSIONS: Vitamin D supplementation may have a preventative effect against upper respiratory infection in patients with IBD but may worsen the symptoms of UC. Oxford University Press 2019-06 2019-01-02 /pmc/articles/PMC6499936/ /pubmed/30601999 http://dx.doi.org/10.1093/ibd/izy346 Text en © 2019 Crohn’s & Colitis Foundation. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Clinical Articles Arihiro, Seiji Nakashima, Akio Matsuoka, Mika Suto, Satoshi Uchiyama, Kan Kato, Tomohiro Mitobe, Jimi Komoike, Nobuhiko Itagaki, Munenori Miyakawa, Yoshinari Koido, Shigeo Hokari, Atsushi Saruta, Masayuki Tajiri, Hisao Matsuura, Tomokazu Urashima, Mitsuyoshi Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza and Upper Respiratory Infection in Patients With Inflammatory Bowel Disease |
title | Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza and Upper Respiratory Infection in Patients With Inflammatory Bowel Disease |
title_full | Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza and Upper Respiratory Infection in Patients With Inflammatory Bowel Disease |
title_fullStr | Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza and Upper Respiratory Infection in Patients With Inflammatory Bowel Disease |
title_full_unstemmed | Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza and Upper Respiratory Infection in Patients With Inflammatory Bowel Disease |
title_short | Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza and Upper Respiratory Infection in Patients With Inflammatory Bowel Disease |
title_sort | randomized trial of vitamin d supplementation to prevent seasonal influenza and upper respiratory infection in patients with inflammatory bowel disease |
topic | Original Clinical Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6499936/ https://www.ncbi.nlm.nih.gov/pubmed/30601999 http://dx.doi.org/10.1093/ibd/izy346 |
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