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Double-blind randomised placebo-controlled trial of bolus-dose vitamin D3 supplementation in adults with asthma (ViDiAs)
  1. Adrian R Martineau1,2,
  2. Beverley D MacLaughlin1,
  3. Richard L Hooper1,
  4. Neil C Barnes1,2,
  5. David A Jolliffe1,
  6. Claire L Greiller1,
  7. Kate Kilpin1,
  8. David McLaughlin1,
  9. Gareth Fletcher1,
  10. Charles A Mein1,
  11. Mimoza Hoti1,
  12. Robert Walton1,
  13. Jonathan Grigg1,
  14. Peter M Timms3,
  15. Raj K Rajakulasingam3,
  16. Angshu Bhowmik3,
  17. Marion Rowe3,
  18. Timothy R Venton3,
  19. Aklak B Choudhury4,
  20. David E Simcock5,
  21. Zia Sadique6,
  22. William R Monteiro7,
  23. Christopher J Corrigan8,
  24. Catherine M Hawrylowicz8,
  25. Christopher J Griffiths1,2,8
  1. 1Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
  2. 2Asthma UK Centre for Applied Research, Blizard Institute, Queen Mary University of London, London, UK
  3. 3Homerton University Hospital, London, UK
  4. 4Queen's Hospital, Rom Valley Way, Romford, London, UK
  5. 5Royal London Hospital, London, UK
  6. 6London School of Hygiene and Tropical Medicine, London, UK
  7. 7NIHR Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
  8. 8MRC and the Asthma UK Centre for Allergic Mechanisms in Asthma, King's College London, London, UK
  1. Correspondence to Professor Adrian R Martineau, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 58 Turner St, London E1 2AB, UK; a.martineau{at}qmul.ac.uk

Abstract

Rationale Asthma exacerbations are commonly precipitated by viral upper respiratory infections (URIs). Vitamin D insufficiency associates with susceptibility to URI in patients with asthma. Trials of vitamin D in adults with asthma with incidence of exacerbation and URI as primary outcome are lacking.

Objective To conduct a randomised controlled trial of vitamin D3 supplementation for the prevention of asthma exacerbation and URI (coprimary outcomes).

Measurements and methods 250 adults with asthma in London, UK were allocated to receive six 2-monthly oral doses of 3 mg vitamin D3 (n=125) or placebo (n=125) over 1 year. Secondary outcomes included asthma control test and St George's Respiratory Questionnaire scores, fractional exhaled nitric oxide and concentrations of inflammatory markers in induced sputum. Subgroup analyses were performed to determine whether effects of supplementation were modified by baseline vitamin D status or genotype for 34 single nucleotide polymorphisms in 11 vitamin D pathway genes.

Main results 206/250 participants (82%) were vitamin D insufficient at baseline. Vitamin D3 did not influence time to first severe exacerbation (adjusted HR 1.02, 95% CI 0.69 to 1.53, p=0.91) or first URI (adjusted HR 0.87, 95% CI 0.64 to 1.16, p=0.34). No clinically important effect of vitamin D3 was seen on any of the secondary outcomes listed above. The influence of vitamin D3 on coprimary outcomes was not modified by baseline vitamin D status or genotype.

Conclusions Bolus-dose vitamin D3 supplementation did not influence time to exacerbation or URI in a population of adults with asthma with a high prevalence of baseline vitamin D insufficiency.

Trial registration number NCT00978315 (ClinicalTrials.gov).

  • Asthma
  • Respiratory Infection
  • Viral infection

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