We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Treatment of vitamin D insufficiency in children and adolescents with inflammatory bowel disease: a randomized clinical trial comparing three regimens.
- Authors
Pappa HM; Mitchell PD; Jiang H; Kassiff S; Filip-Dhima R; DiFabio D; Quinn N; Lawton RC; Varvaris M; Van Straaten S; Gordon CM; Pappa, Helen M; Mitchell, Paul D; Jiang, Hongyu; Kassiff, Sivan; Filip-Dhima, Rajna; DiFabio, Diane; Quinn, Nicolle; Lawton, Rachel C; Varvaris, Mark
- Abstract
<bold>Context: </bold>Vitamin D insufficiency [serum 25-hydroxyvitamin D (25OHD) concentration less than 20 ng/ml] is prevalent among children with inflammatory bowel disease (IBD), and its treatment has not been studied.<bold>Objective: </bold>The aim of this study was to compare the efficacy and safety of three vitamin D repletion regimens.<bold>Design and Setting: </bold>We conducted a randomized, controlled clinical trial from November 2007 to June 2010 at the Clinical and Translational Study Unit of Children's Hospital Boston. The study was not blinded to participants and investigators.<bold>Patients: </bold>Eligibility criteria included diagnosis of IBD, age 5-21, and serum 25OHD concentration below 20 ng/ml. Seventy-one patients enrolled, 61 completed the trial, and two withdrew due to adverse events.<bold>Intervention: </bold>Patients received orally for 6 wk: vitamin D(2), 2,000 IU daily (arm A, control); vitamin D(3), 2,000 IU daily (arm B); vitamin D(2), 50,000 IU weekly (arm C); and an age-appropriate calcium supplement.<bold>Main Outcome Measure: </bold>We measured the change in serum 25OHD concentration (Δ25OHD) (ng/ml). Secondary outcomes included change in serum intact PTH concentration (ΔPTH) (pg/ml) and the adverse event occurrence rate.<bold>Results: </bold>After 6 wk, Δ25OHD ± se was: 9.3 ± 1.8 (arm A); 16.4 ± 2.0 (arm B); 25.4 ± 2.5 (arm C); P (A vs. C) = 0.0004; P (A vs. B) = 0.03. ΔPTH ± SE was -5.6 ± 5.5 (arm A); -0.1 ± 4.2 (arm B); -4.4 ± 3.9 (arm C); P = 0.57. No participant experienced hypercalcemia or hyperphosphatemia, and the prevalence of hypercalciuria did not differ among arms at follow-up.<bold>Conclusions: </bold>Oral doses of 2,000 IU vitamin D(3) daily and 50,000 IU vitamin D(2) weekly for 6 wk are superior to 2,000 IU vitamin D(2) daily for 6 wk in raising serum 25OHD concentration and are well-tolerated among children and adolescents with IBD. The change in serum PTH concentration did not differ among arms.
- Publication
Journal of Clinical Endocrinology & Metabolism, 2012, Vol 97, Issue 6, p2134
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2011-3182