COPD meta-analysis: vitamin D supplements mitigate deficiency

  • Jolliffe DA & al.
  • Thorax
  • 10 Jan 2019

  • curated by Jenny Blair, MD
  • Clinical Essentials
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Takeaway

  • 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.

Key results

  • 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.

Study design

  • 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.

Limitations

  • Most patients were white Europeans.
  • There were not enough studies for researchers to check for publication bias.

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