Association between Vitamin D deficiency and disease activity, disability and radiographic progression in early rheumatoid arthritis. The ESPOIR cohort.
J Rheumatol. 2019 Dec 15. pii: jrheum.190795. doi: 10.3899/jrheum.190795
Mouterde G1, Gamon E1, Rincheval N1, Lukas C1, Seror R1, Berenbaum F1, Dupuy AM1, Daien C1, Daurès JP1, Combe B1.
Rheumatoid Arthritis category starts with
Highlights of RA studies in Vitamin D Life
RA worse if low Vitamin D
- Rheumatoid arthritis pain was 5.8 X more likely if low vitamin D – Aug 2017
- Adaptive and innate immune system, vitamin D genes, and Rheumatoid Arthritis – June 2019
- Every patient with rheumatoid arthritis had low vitamin D, severity was proportional to degree of deficiency – June 2014
- Active Rheumatologic disease was 5X more likely with low vitamin D – June 2013
- Rheumatoid Arthritis strongly associated with low vitamin D – meta-analysis April 2016
- Rheumatoid Arthritis associated with lower vitamin D and higher latitude – meta-analysis Jan 2016
RA and Vitamin D Receptor
- Arthritis runs in Pakistani families (Vitamin D Receptor) – March 2019
- Resveratrol Role in Autoimmune Disease-A Mini-Review. – Dec 2016
- Rheumatoid arthritis is 40 percent more likely if vitamin D Receptor problem – 2 meta-analyses 2015
RA Treated by Vitamin D
- Rheumatoid Arthritis pain reduced by monthly 100,000 IU of Vitamin D – Oct 2018
- Rheumatoid arthritis reduced by 440,000 IU of Vitamin D over 4 months – Oct 2015
- Connective tissue disorders (Lupus, RA, etc) treated by vitamin D – May 2016
- 43 percent of Rheumatoid Arthritis patients have Vitamin D prescriptions (15 countries) – June 2017
- Big increase in vitamin D supplementation in just 2 years after Swiss rheumatology report – Dec 2013
- High dose vitamin reduced pain of fibromyalgia, osteoarthritis, and rheumatoid arthritis - July 2015
- Note: Vitamin D receptor problems (such as RA) are best treated by infrequent large doses of Vitamin D
OBJECTIVE:
To evaluate the association of baseline serum level of vitamin D (vitD) with disease activity, disability and radiographic damage over the first year in early rheumatoid arthritis (RA).
METHODS:
Among early arthritis patients included in the ESPOIR cohort, patients with early RA were evaluated. 25OH vitamin D2D3 level was measured at baseline. Baseline associations between vitD level and DAS28-ESR, Health Assessment Questionnaire Disability Index (HAQ-DI) and van der Heijde-modified total Sharp score (mTSS) were assessed. Bivariate analysis was used to assess the association between vitD level and radiographic progression (mTSS increased by ≥1 point) or disability (HAQ-DI ≥0.5) over 12 months. Forward stepwise multiple logistic regression was used to evaluate the independent association of baseline variables and outcomes.
RESULTS:
Among 813 patients with early arthritis, data for 645 RA patients were analyzed. VitD level was
- <10 ng/ml (deficiency, group 1),
- 10-30 ng/ml (low level, group 2) and
- ≥30 ng/ml (normal, group 3)
- for 114 (17.7%), 415 (64.6%), and 114 (17.7%) patients, respectively.
At baseline, DAS28-ESR and HAQ-DI were higher with vitD deficiency as compared with groups 2 and 3 combined (p=0.007 and p=0.001, respectively) as was mean mTSS but not significantly (p=0.076). On multivariate analysis, baseline vitD deficiency was associated with HAQ-DI at 6 months (OR=1.70) and mTSS at 12 months (OR=1.76).
CONCLUSION:
VitD deficiency was associated with more active and severe disease at baseline and may predict disability and radiographic progression over 1 year in early RA patients.
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