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Article

Effect of Monthly Vitamin D Supplementation on Preventing Exacerbations of Asthma or Chronic Obstructive Pulmonary Disease in Older Adults: Post Hoc Analysis of a Randomized Controlled Trial

1
Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
2
Department of General Practice, University of Otago, Christchurch 8140, New Zealand
3
School of Population Health, University of Auckland, Auckland 1142, New Zealand
4
Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 2QQ, UK
5
Institute for Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
*
Author to whom correspondence should be addressed.
Academic Editors: Spyridon N. Karras and Pawel Pludowski
Nutrients 2021, 13(2), 521; https://doi.org/10.3390/nu13020521
Received: 24 December 2020 / Revised: 28 January 2021 / Accepted: 1 February 2021 / Published: 6 February 2021
Randomized controlled trials have suggested that vitamin D supplementation can prevent asthma and chronic obstructive pulmonary disease (COPD) exacerbations. For COPD, the benefit appears to be limited to individuals with baseline 25-hydroxyvitamin D (25OHD) levels <25 nmol/L. We performed a post hoc analysis of data from a randomized, double-blinded, placebo-controlled trial to investigate the effect that monthly, high-dose vitamin D supplementation (versus placebo) had on older adults with asthma and/or COPD. Specifically, we investigated whether vitamin D supplementation prevented exacerbations of these conditions. Participants were randomly assigned either to an initial oral dose of 200,000 IU vitamin D3 followed by 100,000 IU monthly or to placebo, with an average follow-up period of 3.3 years. Among the 5110 participants, 775 had asthma or COPD at the beginning of the study, and were eligible for inclusion in this analysis. Exacerbations were defined by the prescription of a short-burst of oral corticosteroids. The mean age of the participants was 67 years old, and 56% were male. The mean baseline blood 25OHD level was 63 nmol/L; 2.3% were <25 nmol/L. Overall, we found that vitamin D supplementation did not affect the exacerbation risk (hazard ratio 1.08; 95%CI 0.84–1.39). Among those with baseline 25OHD <25 nmol/L, however, the hazard ratio was 0.11 (95%CI 0.02–0.51); p for interaction = 0.001. Although monthly vitamin D supplementation had no overall impact on risk of exacerbations of asthma or COPD, we found evidence of a probable benefit among those with severe vitamin D deficiency. View Full-Text
Keywords: asthma; chronic obstructive pulmonary disease; exacerbations; oral corticosteroids; randomized controlled trial; supplement; vitamin D asthma; chronic obstructive pulmonary disease; exacerbations; oral corticosteroids; randomized controlled trial; supplement; vitamin D
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MDPI and ACS Style

Camargo, C.A., Jr.; Toop, L.; Sluyter, J.; Lawes, C.M.M.; Waayer, D.; Khaw, K.-T.; Martineau, A.R.; Scragg, R. Effect of Monthly Vitamin D Supplementation on Preventing Exacerbations of Asthma or Chronic Obstructive Pulmonary Disease in Older Adults: Post Hoc Analysis of a Randomized Controlled Trial. Nutrients 2021, 13, 521. https://doi.org/10.3390/nu13020521

AMA Style

Camargo CA Jr., Toop L, Sluyter J, Lawes CMM, Waayer D, Khaw K-T, Martineau AR, Scragg R. Effect of Monthly Vitamin D Supplementation on Preventing Exacerbations of Asthma or Chronic Obstructive Pulmonary Disease in Older Adults: Post Hoc Analysis of a Randomized Controlled Trial. Nutrients. 2021; 13(2):521. https://doi.org/10.3390/nu13020521

Chicago/Turabian Style

Camargo, Carlos A., Jr., Les Toop, John Sluyter, Carlene M.M. Lawes, Debbie Waayer, Kay-Tee Khaw, Adrian R. Martineau, and Robert Scragg. 2021. "Effect of Monthly Vitamin D Supplementation on Preventing Exacerbations of Asthma or Chronic Obstructive Pulmonary Disease in Older Adults: Post Hoc Analysis of a Randomized Controlled Trial" Nutrients 13, no. 2: 521. https://doi.org/10.3390/nu13020521

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