Evaluation of a 12-week targeted vitamin D supplementation regimen in patients with active inflammatory bowel disease

Mayur Garg, Ourania Rosella, Gennaro Rosella, Yunqiu Wu, John S. Lubel, Peter R. Gibson

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18 Citations (Scopus)

Abstract

Background & aims: Vitamin D at serum 25(OH)D concentrations above 100 nmol/L is associated with disease remission in patients with IBD, suggesting targeted dosing might be anti-inflammatory. This study aimed to assess the effectiveness, safety and predictors of a 12-week regimen of vitamin D supplementation to achieve such a target in patients with active disease. Methods: In a pilot study, patients with active colitis and a serum 25(OH)D concentration <75 nmol/L were prescribed oral liquid vitamin D supplementation over 12 weeks using a specific protocol with dose adjusted 4-weekly to aim for a target level of 100-125 nmol/L. Results: Five patients each with Crohn's colitis or ulcerative colitis (UC) had mean 25(OH)D concentration 52 (range 27-73 nmol/L). Five reached the targeted level and four 89-95 nmol/L. One withdrew after 4 weeks (88 nmol/L). Target dose was met only in those with BMI <30 kg/m2 and total dose inversely correlated with initial serum 25(OH)D. One patient had developed a high level at 8 weeks (146 nmol/L) and another new hypercalciuria. There were no serious adverse events attributable to the therapy. Clinical disease activity consistently declined, but faecal calprotectin and circulating markers of inflammation did not. Conclusions: A specified oral vitamin D regimen successfully and safely achieved target or near-target levels, improved symptom-based activity scores, but did not alter objective measures of intestinal or systemic inflammation. A modified version of this dose-escalating regimen would be suitable for a randomised placebo-controlled trial, but does require regular safety monitoring.

Original languageEnglish
Pages (from-to)1375-1382
Number of pages8
JournalClinical Nutrition
Volume37
Issue number4
DOIs
Publication statusPublished - Aug 2018

Keywords

  • Cholecalciferol
  • Colitis
  • Crohn's disease
  • Inflammatory bowel diseases
  • Ulcerative colitis
  • Vitamin D

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