Researchers at Brigham and Women’s Hospital in Boston analysed data from 173 IBD patients with information on both vitamin D levels and the success of treatment for their condition.
Better odds with normal vitamin D levels
They found a clear link between vitamin D status and remission of the disease, with those with normal vitamin D levels at the start of treatment more than 2.5-times as likely to go into remission after three months of treatment with anti-TNF medication, a common treatment for inflammatory conditions.
“These results show a significant association between vitamin D levels and rates of remission among patients with IBD. Specifically, patients who had low vitamin D levels prior to treatment had decreased odds of being in remission after three months of treatment with anti-TNF-α therapy,” wrote the researchers in a paper published in the journal Alimentary Pharmacology & Therapeutics.
The authors noted that studies in mice had previously linked vitamin D to the successful treatment of colitis, and referenced other studies which also suggested – but did not demonstrate to significance – a link between vitamin D and IBD.
They also said the mechanism by which vitamin D affects bowel inflammation was not entirely clear, but suggested its influence on B and T cells may result in increased production of anti-inflammatory cytokines – small proteins secreted by cells – and decreased production of inflammatory cytokines.
Should IBD be treated with vitamin D?
“These findings may have clinical implications as we have shown that vitamin D levels are associated with initial response to anti-TNF-α therapy,” wrote the authors.
“If our findings are confirmed in larger studies, recommendations for clinical management of IBD may include therapy with vitamin D. Further study regarding optimal timing and dosing of vitamin D supplementation should be clarified in future investigations.
“Furthermore, because of a variety of assays used in our patients, we dichotomised results as below normal or normal. We were not able to explore whether higher levels – even within normal – may improve outcomes,” they added.
The authors noted their study was undersized and based on results from a single centre, and called for larger, wider investigations into the link between vitamin D and IBD treatment. They also highlighted their inability to be more specific than categorising patients with “low” or “normal” vitamin D levels, because of the disparate methods used to measure vitamin D status in patients looked at for the study.
Takeda Pharmaceuticals USA provided funding for this project, according to a disclosure by the authors.
Source: Alimentary Pharmacology & Therapeutics
Published online ahead of print, doi: 10.1111/apt.13936
“Higher 25-hydroxyvitamin D levels are associated with greater odds of remission with anti-tumour necrosis factor-α medications among patients with inflammatory bowel diseases”
Authors: Winter, R. W., Collins, E., Cao, B., Carrellas, M., Crowell, A. M. and Korzenik, J. R.