Vitamin D3 therapy did not reduce the rate of first treatment failure or exacerbation in adults with lower vitamin D levels and persistent asthma, according to recent study results.
“Vitamin D supplementation in [those] patients did not improve their asthma control,” Mario Castro, MD, MPH, Alan A. and Edith L. Wolff Professor of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, told Healio.com. “However, the patients in the treatment group that achieved vitamin D sufficiency in the blood [mean 42 ng/mL) did show improved asthma control with half the number of asthma attacks.”
Castro and colleagues conducted a double blind study of 1,523 adults with symptomatic asthma and a serum 25-hydroxyvitamin level of less than 30 ng/mL at nine academic US medical centers between April 2011 and January 2014. Four hundred eight patients were randomly assigned to oral vitamin D3 treatment (100,000 IU once, then 4,000 IU daily for 28 weeks; n=201; mean age 39.9 years; 31.8% men) or placebo (n=207; mean age, 39.5 years; 31.9% men) added to inhaled ciclesonide (320 mcg daily).
Ciclesonide was lowered to 160 mcg/day for 8 weeks if asthma control was achieved at 12 weeks; with asthma control maintenance, ciclesonide was reduced to 80 mcg/day.
There was a 28% treatment failure rate (95% CI, 21%-34%) for patients treated with vitamin D3 for 28 weeks vs. 29% (95% CI, 23%-35%) for placebo patients (adjusted OR=0.9; 95% CI, 0.6-1.3). Asthma exacerbation was among nine of 14 secondary outcomes analyzed. The only statistically significant outcome was the difference in overall ciclesonide dose necessary to maintain asthma control (14.9 mcg/day; 95% CI, 2.1-27.7 mcg/day) in the cohort receiving vitamin D3 (111.3 mcg/day; 95% CI, 102.2-120.4 mcg/day) compared with the placebo cohort (126.2 mcg/day; 95% CI, 117.2-135.3 mcg/day).
Disclosure: See the study for a full list of relevant financial disclosures.