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Can vitamin D supplementation prevent bone loss in persons with MS? A placebo-controlled trial
Linn H Steffensen1, Lone Jørgensen, Bjørn Straume
1Department of Neurology, University Hospital of North Norway, Tromsø, Norway. linn.hofsoy.steffensen@unn.no
Abstract:
Multiple sclerosis (MS) is a possible cause of secondary osteoporosis. In this phase II trial we assessed whether a weekly dose of 20,000 IU vitamin D(3) prevents bone loss in ambulatory persons with MS age 18-50 years. ClinicalTrials.gov ID NCT00785473. All patients managed at the University Hospital of North Norway who fulfilled the main inclusion criteria were invited to participate in this double-blinded trial. Participants were randomised to receive 20,000 IU vitamin D(3) or placebo once a week and 500 mg calcium daily for 96 weeks. The primary outcome was the effect of the intervention on percentage change in bone mineral density (BMD) at the hip, the spine, and the ultradistal radius over the study period. Of 71 participants randomised, 68 completed. Mean serum 25-hydroxyvitamin D [25(OH)D] levels in the intervention group increased from 55 nmol/L at baseline to 123 nmol/L at week 96. After 96 weeks, percentage change in BMD did not differ between groups at any site. BMD decreased at the hip, by 1.4% in the placebo group (95% CI -2.3 to -0.4, SD 2.7, p = 0.006) and by 0.7% in the treatment group (-1.6 to 0.2, 2.7, p = 0.118), difference 0.7% (-1.9 to 0.7, p = 0.332). Findings were not altered by adjustment for sex or serum 25(OH)D. Supplementation with 20,000 IU vitamin D(3) a week did not prevent bone loss in this small population. Larger studies are warranted to assess the effect of vitamin D on bone health in persons with MS.
Insights
Weekly vitamin D3 supplementation did not prevent bone loss in multiple sclerosis (MS) patients. Higher doses of vitamin D3 did not significantly alter bone mineral density (BMD) changes over 96 weeks in this study population.
Area of Science:
- Neurology
- Endocrinology
- Bone Metabolism
Background:
- Multiple sclerosis (MS) is linked to secondary osteoporosis.
- Bone health is a concern for individuals with MS.
Purpose of the Study:
- To assess if weekly vitamin D3 supplementation prevents bone loss in ambulatory adults with MS.
- To evaluate the effect of 20,000 IU vitamin D3 on bone mineral density (BMD) in MS patients.
Main Methods:
- A double-blind, placebo-controlled phase II trial.
- 71 ambulatory MS patients (age 18-50) received weekly 20,000 IU vitamin D3 or placebo with daily calcium for 96 weeks.
- Primary outcome: percentage change in BMD at hip, spine, and ultradistal radius.
Main Results:
- Mean serum 25(OH)D levels increased significantly in the vitamin D3 group.
- No significant difference in BMD percentage change between groups at any site after 96 weeks.
- BMD at the hip decreased in both placebo (1.4%) and vitamin D3 (0.7%) groups, but the difference was not significant.
Conclusions:
- Weekly high-dose vitamin D3 supplementation (20,000 IU) did not prevent bone loss in this small cohort of MS patients.
- Further research with larger populations is needed to clarify vitamin D's role in MS-related bone health.
- Bone mineral density may decrease in MS patients despite vitamin D supplementation.
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