2024-04-25 09:43:05
The Epi-Phare study had identified more than 385,000 cases of people suffering from rheumatoid arthritis medically followed in 2019 in France, or 0.47% of the population. Furthermore, it is now accepted that vitamin D plays a key role in modulating the innate and adaptive immune response to various pathogens and inflammatory and autoimmune diseases. However, the results of studies on the relationship between vitamin D deficiency and RA activity are still conflicting.
The meta-analysis presented here is based on 11 studies published through 2022, 3049 patients.
The results show that vitamin D supplementation will not significantly reduce CRP, ESR, DAS28 or HAQ. It should be noted that the results related to grants were very heterogeneous.
In contrast, pooled analysis showed that vitamin D significantly reduced pain (as measured by the weighted mean difference [DMP] pain assessed on the visual analogue scale [EVA] : -1.30 [-2,34 à -27]p=0.01, I2=80%, p=0.0005), the disease activity score linked to CRP (DAS28-CRP, DMP = -0.58 [-0,86 à -0,31]p<0.0001, I2=25%, p=0.26) et/ou à la vitesse de sédimentation des erytrocytes (DAS28-VS, DMP = -0.58 [-0,86 à -0,31]p=0.0001, I2=0.25, p=0.26).
Subgroup analyzes showed a significant beneficial effect from doses >100 micrograms/day on CRP (p<0,05), mais pas sur la VS (p>0.05).
The authors mention the significant biases of certain studies, particularly lack of randomization or blinded evaluation. Further robust studies including baseline vitamin D levels, age, dietary vitamin D intake, time of year, sun exposure, drug interactions, dose of effect, etc., are therefore needed before judging the benefit of vitamin D supplementation in patients with RA .
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