Is Vitamin D Effective on the Disease Activity Index (DAS28) in Rheumatoid Arthritis?

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Associate Professor, Department of Community and Preventive Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: We can prevent developing osteoporosis in rheumatoid arthritis (RA) patients with compounds containing calcium and vitamin D. In some of the studies, patients who received more vitamin D had better disease control. Our aim in this study was to observe whether the vitamin D could be effective on the rheumatoid arthritis disease activity or not?Methods: This study was a double blind randomized controlled clinical trial on 117 patients with rheumatoid arthritis. In Intervention group, in addition to drug therapy, vitamin D 50000 units per week were prescribed. Control group also received placebo tablets. In the end of study, results in both groups compared. Data analysis was performed by paired t-test, Student t-test and General linear Model.Finding: There were no significant differences in baseline disease severity, and DAS-28 in both groups. DAS-28 in intervention and control groups was 5.4 ± 1.1 and 5.5 ± 1.3, respectively (P > 0.05). In both groups, all clinical and laboratory parameters after intervention were reduced. The amount of reductions in intervention group was more than the placebo group but it is not significant.Conclusion: According to this research vitamin D can use as an adjuvant therapy for rheumatoid arthritis. 

Keywords


  1. Majithia V, Geraci SA. Rheumatoid arthritis: diagnosis and management. Am J Med 2007; 120(11): 936-9.
  2. Cutolo M, Otsa K, Laas K, Yprus M, Lehtme R, Secchi ME, et al. Circannual vitamin d serum levels and disease activity in rheumatoid arthri-tis: Northern versus Southern Europe. Clin Exp Rheumatol 2006; 24(6): 702-4.
  3. Frediani B, Rossini M, Adami S, Bianchi G, Di MO, Sinigaglia L, et al. [Study of vitamin D sta-tus of rheumatoid arthritis patients. Rationale and design of a cross-sectional study by the os-teoporosis and metabolic bone diseases study group of the Italian Society of Rheumatology (SIR)]. Reumatismo 2006; 58(4): 314-8.
  4. Kroger H, Penttila IM, Alhava EM. Low serum vitamin D metabolites in women with rheuma-toid arthritis. Scand J Rheumatol 1993; 22(4): 172-7.
  5. Cantorna MT, Mahon BD. Mounting evidence for vitamin D as an environmental factor affect-ing autoimmune disease prevalence. Exp Biol Med (Maywood) 2004; 229(11): 1136-42.
  6. Arnson Y, Amital H, Shoenfeld Y. Vitamin D and autoimmunity: new aetiological and thera-peutic considerations. Ann Rheum Dis 2007; 66(9): 1137-42.
  7. Cutolo M, Otsa K, Uprus M, Paolino S, Seriolo B. Vitamin D in rheumatoid arthritis. Autoimmun Rev 2007; 7(1): 59-64.
  8. Cantorna MT. Vitamin D and autoimmunity: is vitamin D status an environmental factor affect-ing autoimmune disease prevalence? Proc Soc Exp Biol Med 2000; 223(3): 230-3.
  9. May E, Asadullah K, Zugel U. Immunoregula-tion through 1, 25-dihydroxyvitamin D3 and its analogs. Curr Drug Targets Inflamm Allergy 2004; 3(4): 377-93.
  10. Oelzner P, Muller A, Deschner F, Huller M, Abendroth K, Hein G, et al. Relationship be-tween disease activity and serum levels of vita-min D metabolites and PTH in rheumatoid ar-thritis. Calcif Tissue Int 1998; 62(3): 193-8.
  11. Costenbader KH, Feskanich D, Holmes M, Karlson EW, Benito-Garcia E. Vitamin D intake and risks of systemic lupus erythematosus and rheumatoid arthritis in women. Ann Rheum Dis 2008; 67(4): 530-5.
  12. Merlino LA, Curtis J, Mikuls TR, Cerhan JR, Criswell LA, Saag KG. Vitamin D intake is in-versely associated with rheumatoid arthritis: re-sults from the Iowa Women's Health Study. Ar-thritis Rheum 2004; 50(1):72-7.
  13. Kaarela K, Kauppi MJ, Lehtinen KE. The value of the ACR 1987 criteria in very early rheuma-toid arthritis. Scand J Rheumatol 1995; 24(5): 279-81.
  14. Prevoo ML, van 't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts. Development and val-idation in a prospective longitudinal study of pa-tients with rheumatoid arthritis. Arthritis Rheum 1995; 38(1): 44-8.
  15. Andjelkovic Z, Vojinovic J, Pejnovic N, Popovic M, Dujic A, Mitrovic D, et al. Disease modifying and immunomodulatory effects of high dose 1 alpha (OH) D3 in rheumatoid arthritis patients. Clin Exp Rheumatol 1999; 17(4): 453-6.