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

Research output: Contribution to journalArticleResearchpeer-review

14 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

Cite this

@article{d2d6e87a1a8c4463b85bc6681af92844,
title = "Evaluation of a 12-week targeted vitamin D supplementation regimen in patients with active inflammatory bowel disease",
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.",
keywords = "Cholecalciferol, Colitis, Crohn's disease, Inflammatory bowel diseases, Ulcerative colitis, Vitamin D",
author = "Mayur Garg and Ourania Rosella and Gennaro Rosella and Yunqiu Wu and Lubel, {John S.} and Gibson, {Peter R.}",
year = "2018",
month = "8",
doi = "10.1016/j.clnu.2017.06.011",
language = "English",
volume = "37",
pages = "1375--1382",
journal = "Clinical Nutrition",
issn = "0261-5614",
publisher = "Elsevier",
number = "4",

}

Evaluation of a 12-week targeted vitamin D supplementation regimen in patients with active inflammatory bowel disease. / Garg, Mayur; Rosella, Ourania; Rosella, Gennaro; Wu, Yunqiu; Lubel, John S.; Gibson, Peter R.

In: Clinical Nutrition, Vol. 37, No. 4, 08.2018, p. 1375-1382.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Evaluation of a 12-week targeted vitamin D supplementation regimen in patients with active inflammatory bowel disease

AU - Garg, Mayur

AU - Rosella, Ourania

AU - Rosella, Gennaro

AU - Wu, Yunqiu

AU - Lubel, John S.

AU - Gibson, Peter R.

PY - 2018/8

Y1 - 2018/8

N2 - 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.

AB - 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.

KW - Cholecalciferol

KW - Colitis

KW - Crohn's disease

KW - Inflammatory bowel diseases

KW - Ulcerative colitis

KW - Vitamin D

UR - http://www.scopus.com/inward/record.url?scp=85021234785&partnerID=8YFLogxK

U2 - 10.1016/j.clnu.2017.06.011

DO - 10.1016/j.clnu.2017.06.011

M3 - Article

VL - 37

SP - 1375

EP - 1382

JO - Clinical Nutrition

JF - Clinical Nutrition

SN - 0261-5614

IS - 4

ER -