Vitamin D supplementation reduces COPD flare-ups in vitamin D deficient patients

by Bruce Sylvester: Vitamin D supplementation appears to lower the incidence of COPD (chronic obstructive pulmonary disease) lung disease flare-up by over 40% in patients with a vitamin D deficiency, researchers reported on Dec. 1, 2014 in the journal Lancet Respiratory Medicine

Lead author, Dr. Adrian Martineau of Queen Mary University of London, said, “Flare-ups of chronic bronchitis and emphysema (COPD) can be debilitating for patients, sometimes leading to hospitalisation and even death. Our research has shown how an inexpensive vitamin supplement can significantly reduce the risk of flare-ups for patients who are vitamin D deficient, which could have a major public health benefit. Our findings suggest that patients with COPD should have their vitamin D status tested and should begin taking supplements if their levels are found to be low.”

The trial enrolled included 240 patients with COPD in and around London.

One-hundred and twenty two subjects received vitamin D supplements (6 x 2-monthly oral doses of 3mg) and118 received a placebo. The investigators compared the risk, severity and duration of COPD flare-ups. The investigators defined “flare-ups” as a unrelieved worsening of COPD symptoms (coughing, excess mucus, shortness of breath, tightness in chest).

Compared with placebo, vitamin D treatment did not affect time to first moderate or severe exacerbation (p=0·42) or time to first upper respiratory infection (p=0·75).

However, a subgroup analysis revealed that vitamin D was significantly protective against moderate or severe exacerbation in participants with baseline serum 25-hydroxyvitamin D concentrations of less than 50 nmol/L (p=0·021), but not in those with baseline 25-hydroxyvitamin D levels of at least 50 nmol/L (p=0·21; p=0·021 for interaction between allocation and baseline serum 25-hydroxyvitamin D status).

The authors concluded, “Vitamin D₃ supplementation protected against moderate or severe exacerbation, but not upper respiratory infection, in patients with COPD with baseline 25-hydroxyvitamin D levels of less than 50 nmol/L. Our findings suggest that correction of vitamin D deficiency in patients with COPD reduces the risk of moderate or severe exacerbation.”

They added, “This is the first clinical trial to investigate the impact of vitamin D supplementation on severity and duration of COPD symptoms. One previous trial has linked vitamin D to a reduction in COPD disease flare ups but this was limited to patients with very severe conditions. This trial is larger and studied patients with a much broader spectrum of diseases, ranging from mild to severe.”