Treatment and prevention of vitamin D insufficiency in cystic fibrosis patients: comparative efficacy of ergocalciferol, cholecalciferol, and UV light

J Clin Endocrinol Metab. 2009 Jun;94(6):2037-43. doi: 10.1210/jc.2008-2012. Epub 2009 Mar 31.

Abstract

Background: The optimal treatment for correcting or preventing vitamin D insufficiency in cystic fibrosis (CF) patients has not been established.

Objective: The aim of the study was to assess the relative efficacy of three modes of vitamin D therapy: cholecalciferol (D3), ergocalciferol (D2), and UV light in raising or maintaining 25(OH)D levels above 30 ng/ml.

Design: Thirty adult CF subjects with vitamin D insufficiency were randomized into one of three treatment arms: D3, D2, or UV light. Subjects randomized to D3 or D2 ingested 50,000 IU of vitamin D weekly, and those randomized to UV exposed their skin to UV light from a lamp five times a week. Serum was collected for 25(OH)D and PTH at baseline and at 12 wk.

Results: Treatment with D3 and D2 raised 25(OH)D levels significantly, from a mean of 21.2 +/- 10.18 to 47.1 +/- 20.5 ng/ml (P < 0.001) and 24.4 +/- 10.3 to 32.7+/- 9.7 ng/ml (P = 0.01), with 100% and 60% reaching 25(OH)D levels above 30 ng/ml, respectively. Treatment with UV did not raise 25(OH)D levels significantly; however, only 55% of subjects were adherent with UV therapy.

Conclusion: This study demonstrates that CF subjects are able to achieve or maintain optimal vitamin D status (>30 ng/ml) with two oral regimens of either D3 or D2 treatment, the former being more efficacious. A confounding variable for this observation is the fact that the D3 and D2 capsules contained different carriers, powder-based vs. oil-based, respectively. UV therapy did not alter vitamin D status, possibly due to poor adherence to UV therapy.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cholecalciferol / adverse effects
  • Cholecalciferol / blood
  • Cholecalciferol / therapeutic use*
  • Cystic Fibrosis / therapy*
  • Ergocalciferols / adverse effects
  • Ergocalciferols / blood
  • Ergocalciferols / therapeutic use*
  • Female
  • Humans
  • Hydroxycholecalciferols / blood
  • Male
  • Middle Aged
  • Parathyroid Hormone / blood
  • Patient Compliance
  • Ultraviolet Therapy* / adverse effects
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / prevention & control*
  • Vitamin D Deficiency / therapy*
  • Young Adult

Substances

  • Ergocalciferols
  • Hydroxycholecalciferols
  • Parathyroid Hormone
  • Cholecalciferol