High-dose vitamin D does not reduce endoscopic recurrence of Crohn’s
For patients who underwent ileocolonic resection with ileocolonic anastomosis, high-dose vitamin D did not reduce the incidence of postoperative endoscopic or clinical recurrence of Crohn’s disease, according to recently published results.
“We are the first to study CD activity during treatment with vitamin D using endoscopy,” Jessica R. de Bruyn, MD, of department of gastroenterology and hepatology from the Amsterdam Inflammatory Bowel Disease Center and Amsterdam Gastroenterology and Metabolism, Amsterdam University Medical Center at University of Amsterdam, and colleagues wrote. “Given all the above, we could not observe any anti-inflammatory effect with this regimen in postoperative CD.”
Researchers randomly assigned patients with CD who underwent ileocolonic resection with ileocolonic anastomosis to receive weekly either 25,000 IU oral vitamin D (n = 72) or placebo (n = 71) for 26 weeks at 17 hospitals in the Netherlands and Belgium between February 2014 and June 2017. At baseline and weeks 2, 6, 12 and 26, investigators evaluated patients for laboratory and clinical parameters and at 26 weeks patients underwent ileocolonoscopy. Endoscopic recurrence at 26 weeks served as the study’s endpoint. Other endpoints included clinical recurrence, quality of life (measured by SF-36, IBD-Q and EQ-5D) and outcomes correlated with baseline serum concentration of vitamin D.
Results showed serum levels of 25-hydroxy vitamin D increased from median 42 nmol/L at baseline to 81 nmol/L at week 26 in the vitamin D group. Meanwhile in the placebo group levels did not significantly change and remained unchanged at 43 nmol/L.
According to results from the intent-to-treat analysis, the proportion of patients with endoscopic recurrence at 26 weeks was not significantly different between the vitamin D group and placebo group (58% vs 66%). There was no significant difference in the cumulative rate of clinical recurrence between the groups (18.1% in the vitamin D group vs 18.3% in the placebo group). Overtime, quality of life slightly improved in both groups; however, it was not significantly different between groups. (P > .07). Few adverse events were seen in either group