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Am J Respir Crit Care Med. 2016 Mar 15;193(6):634-41. doi: 10.1164/rccm.201506-1169OC.

Vitamin D Supplementation and the Risk of Colds in Patients with Asthma.

Author information

1
1 Department of Medicine and.
2
2 Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
3
3 Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.
4
4 Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts.
5
5 Department of Pediatrics and.
6
6 Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
7
7 Department of Medicine, Duke University School of Medicine, Durham, North Carolina.
8
8 Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
9
9 Department of Pediatrics, Rainbow Babies & Children's Hospital, Cleveland, Ohio.
10
10 Department of Medicine, Washington University in St. Louis, St. Louis, Missouri.
11
11 Department of Medicine, University of California San Francisco, San Francisco, California.
12
12 Department of Medicine, National Jewish Health, Denver, Colorado; and.
13
13 Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Abstract

RATIONALE:

Restoration of vitamin D sufficiency may reduce asthma exacerbations, events that are often associated with respiratory tract infections and cold symptoms.

OBJECTIVES:

To determine whether vitamin D supplementation reduces cold symptom occurrence and severity in adults with mild to moderate asthma and vitamin D insufficiency.

METHODS:

Colds were assessed in the AsthmaNet VIDA (Vitamin D Add-on Therapy Enhances Corticosteroid Responsiveness) trial, in which 408 adult patients were randomized to receive placebo or cholecalciferol (100,000 IU load plus 4,000 IU/d) for 28 weeks as add-on therapy. The primary outcome was cold symptom severity, which was assessed using daily scores on the 21-item Wisconsin Upper Respiratory Symptom Survey.

MEASUREMENTS AND MAIN RESULTS:

A total of 203 participants experienced at least one cold. Despite achieving 25-hydroxyvitamin D levels of 41.9 ng/ml (95% confidence interval [CI], 40.1-43.7 ng/ml) by 12 weeks, vitamin D supplementation had no effect on the primary outcome: the average peak WURSS-21 scores (62.0 [95% CI, 55.1-68.9; placebo] and 58.7 [95% CI, 52.4-65.0; vitamin D]; P = 0.39). The rate of colds did not differ between groups (rate ratio [RR], 1.2; 95% CI, 0.9-1.5); however, among African Americans, those receiving vitamin D versus placebo had an increased rate of colds (RR, 1.7; 95% CI, 1.1-2.7; P = 0.02). This was also observed in a responder analysis of all subjects achieving vitamin D sufficiency, regardless of treatment assignment (RR, 1.4; 95% CI, 1.1-1.7; P = 0.009).

CONCLUSIONS:

Our findings in patients with mild to moderate asthma undergoing an inhaled corticosteroid dose reduction do not support the use of vitamin D supplementation for the purpose of reducing cold severity or frequency.

KEYWORDS:

WURSS-21; asthma; upper respiratory tract infection; vitamin D

Comment in

PMID:
26540136
PMCID:
PMC4824938
DOI:
10.1164/rccm.201506-1169OC
[Indexed for MEDLINE]
Free PMC Article

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