NASHVILLE -- Preliminary findings from an ongoing retrospective analysis failed to show a statistically significant relationship between vitamin D supplementation and multiple sclerosis (MS) relapse, but there was a suggestion of a benefit in the findings, researchers reported here.
The retrospective study was done in MS patients, the majority of whom had relapsing-remitting disease, and who took vitamin D2 (600-50,000 IU daily) or vitamin D3 (1,000-50,000 IU daily). A cross-sectional analysis showed that 38 were on vitamin D, and six of them had a relapse, while 62 were not on vitamin D and 19 of had a relapse, according to Renu Pokharna, MD, of the University of South Carolina School of Medicine in Columbia, and colleagues.
Action Points
- Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
The chart review analysis was small, with just 100 patients, and Pokharna said the group hopes to expand it to around 1,000 patients by the end of the year.
"That should give us a better idea of the impact of taking vitamin D on multiple sclerosis relapse," Pokharna said at the Consortium of Multiple Sclerosis Centers annual meeting.
Previous research examining the impact of vitamin D supplementation on MS relapse has been mixed, with some studies showing a benefit and others showing no relationship.
Vitamin D has been shown to have anti-inflammatory effects, including in the autoimmune encephalitis model that is associated with inflammation in MS. There has also been a suggestion that vitamin D could affect remyelination, independent of its effect on inflammation.
In , Danish found that giving oral vitamin D supplements (2,000-4,000 IU daily) to patients with relapsing-remitting MS with low baseline serum 25(OH)D levels was associated with significantly lower annualized relapse rates. However, the study had <200 patients.
examining vitamin D supplementation in MS identified seven studies totaling just 284 patients. The analysis suggested that while vitamin D supplementation may have a therapeutic role in the treatment of MS, uncertainty about the appropriate dosage remains, with a suggestion of worse outcomes with higher doses. The concluded that large, well designed and well executed studies are needed to better understand the role of vitamin D supplementation, if any, in MS treatment.
Pokharna's group enrolled patients with a mean age of 36.34. Of those, 72% were female and 46% were white. They reported that the χ2 test showed an association between vitamin D and MS relapses, but it was not statistically significant (χ2=2.04, P=0.15, odds ratio 0.42, 95% CI 0.15-1.19).
Pokharna told ľֱ that in the absence of such trials, a large retrospective analysis like the one her group plans could provide some answers.
"Much more research needs to be done in order to investigate this relationship further and the possible positive effect (supplementation) could have on MS patients," she said. "This early research helped us estimate the needed sample size for a prospective study that will hopefully answer these questions."
Disclosures
Pokharna and co-authors disclosed no relevant relationships with industry.
Primary Source
Consortium of Multiple Sclerosis Centers
Pokharna R, et al "Effect of vitamin D on multiple sclerosis relapse" CMSC 2018; Abstract CA02.