Vitamin D supplementation and disease activity in patients with immune-mediated rheumatic diseases: A systematic review and meta-analysis

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art_FRANCO_Vitamin_D_supplementation_and_disease_activity_in_patients_2017.PDF (452.74 KB)
Citações na Scopus
66
Tipo de produção
article
Data de publicação
2017
Editora
LIPPINCOTT WILLIAMS & WILKINS
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
BERNARDO, Wanderley M.
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
MEDICINE, v.96, n.23, article ID e7024, 9p, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background:Vitamin D serum levels and the presence and activity of rheumatic conditions have been associated. However, many studies are merely observational, and the existent randomized clinical trials were never systematically analyzed. Therefore, this study aims to provide a systematic review and meta-analysis of such a topic.Methods:MEDLINE, EMBASE, LILACS, COCHRANE, and CINAHL were explored to identify randomized trials that investigated clinical repercussions of vitamin D (or analogs) supplementation for at least 3 months in rheumatic diseases. Standardized clinical and/or laboratorial outcomes related to disease activity were analyzed according to each disease before and after supplementation.Results:Database searches rendered 668 results; 9 were included5 on rheumatoid arthritis, 3 on systemic lupus erythematosus, and 1 on systemic sclerosis. Seven of the studies were meta-analyzed. After vitamin D supplementation, rheumatoid arthritis recurrence decreased; however, not significantly (risk difference=-0.10, 95% CI=-0.21, 0.00, P=.05). No statistical significance was observed regarding visual analog scale (mean difference=2.79, 95% CI=-1.87, 7.44, P=.24) and disease activity score28 (mean difference=-0.31, 95% CI=-0.86, 0.25, P=.28). Regarding systemic lupus erythematosus, anti-dsDNA positivity was significantly reduced (risk difference=-0.10, 95% CI=-0.18, -0.03; P=.005).Conclusion:Vitamin D supplementation reduced anti-dsDNA positivity on systemic lupus erythematosus and could possibly reduce rheumatoid arthritis recurrence, although novel randomized clinical trials are needed to confirm and extend the benefits of this hormone in immune-mediated rheumatic diseases.
Palavras-chave
disease activity, meta-analysis, rheumatic diseases, rheumatoid arthritis, systemic lupus erythematosus, vitamin D
URI
https://observatorio.fm.usp.br/handle/OPI/21215
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - LIM/13
Artigos e Materiais de Revistas Científicas - LIM/17