- Vitamin D supplementation for low baseline vitamin D levels is tied to fewer moderate-severe COPD exacerbations, according to this meta-analysis of individual patient data from randomized controlled trials (RCTs).
- Authors hypothesize “exacerbations in the vitamin D-deficient group may be largely driven by vitamin D deficiency,” vs by other factors in nondeficient group.
Why this matters
- These trials found conflicting results and have not previously been meta-analyzed.
- With vitamin D vs without: adjusted incidence rate ratio (aIRR), 0.94 (95% CI, 0.78-1.13; P=.52) (3 studies; 469 participants; high-quality evidence).
- Upon subgroup analysis, benefit was driven by patients with baseline serum 25(OH)D
- No subgroup effects seen at higher baseline vitamin D levels, or with COPD grade, use of inhaled corticosteroids at baseline, BMI, dosing frequency, or genotype.
- Bias risk deemed low.
- Systematic review and meta-analysis of 4 double-blind, placebo-controlled RCTs (n=560); individual patient data found for 469.
- Outcome: rate of moderate or severe COPD exacerbations.
- Funding: National Institute of Health Research.
- Most patients were white Europeans.
- There were not enough studies for researchers to check for publication bias.