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Clin Exp Rheumatol. 2019 Sep 17. [Epub ahead of print]

Is cholecalciferol a potential disease modifying anti-rheumatic drug for the management of rheumatoid arthritis?

Author information

1
Dept. Translational Med, Università del Piemonte Orientale UPO; Div. of Internal Medicine, Immuno-Rheumatology Unit, Ctre Translational Research on Autoimmune & Allergic Disease, Hosp. Maggiore della Carità, Interdisciplinary Res. Ctr. Autoimmune Dis, Novara, Italy.
2
Rheumatology and Clinical Immunology Unit and Department of Clinical and Experimental Sciences, Spedali Civili and University of Brescia, Italy.
3
IRCAD, Interdisciplinary Research Centre of Autoimmune Diseases, Novara, Italy; and Centre for Experimental Medicine and Rheumatology, Barts and The London School of Medicine and Dentistry, William Harvey Research Inst., Queen Mary Univ. of London, UK.
4
Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, and Emergency Medicine Department, "Maggiore della Carità" Hospital, Novara, Italy.
5
Department of Translational Medicine, Università del Piemonte Orientale UPO; and Division of Internal Medicine, Immuno-Rheumatology Unit, Center for Translational Research on Autoimmune and Allergic Disease, "Maggiore della Carità" Hosp., Novara, Italy.

Abstract

Vitamin D is a pleiotropic molecule with a well-characterised immunomodulatory activity in vitro; however, its potential clinical application in autoimmune conditions has yet to be clarified. Several authors have investigated the use of vitamin D as a disease-modifying anti-rheumatic drug (DMARD) in rheumatoid arthritis (RA), obtaining divergent conclusions. This systematic review summarises and critically analyses the findings of papers assessing the impact of vitamin D supplementation on pain relief, disease activity, functional status and flare rate. We conclude that the correction of hypovitaminosis D may have a beneficial effect on pain perception; moreover, the achievement of an adequate plasma vitamin D concentration obtained with high-dose regimens might evoke immunomodulatory activities of vitamin D and favourably impact on disease control. Nevertheless, the current evidence is still not strong enough to support the use of cholecalciferol as a DMARD in RA, and further studies are required to clarify this issue.

PMID:
31573472

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