维生素D在临床隔离综合征后没有降低多发性硬化症疾病的活性
Helmut Butzkueven1, Anne-Louise Ponsonby2, Mark S Stein3
1Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3004, Australia.
Brain : a journal of neurology
|December 12, 2023
概括
高剂量的维生素D3补充剂并没有防止临床隔离综合征患者转化为多发性硬化症. 这项研究发现,使用维生素D3并没有显著降低疾病活动,尽管维生素D3是安全的,并且耐受性很好.
科学领域:
- 神经学 神经学
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
背景情况:
- 低血清25-基维生素D [25(OH) D]和减少阳光照射是多发性硬化症 (MS) 的确立危险因素.
- 之前在已确诊多发性硬化症患者中补充维生素D的试验得出了不确定的结果.
- 维生素D补充剂在预防从临床隔离综合征 (CIS) 转化MS的有效性仍然是未知的.
研究的目的:
- 调查口服维生素D3补充剂是否会延迟高风险CIS患者转化为明确的MS.
- 为了确定任何治疗效果是否依赖于剂量.
- 评估不同剂量的维生素D3的安全性和耐受性.
主要方法:
- 一个双盲,随机对照试验,涉及204名参与者在澳大利亚和新西兰的高风险CIS.
- 参与者被分配给安慰剂,1000,5000或10,000国际单位口服维生素D3每天,长达48周.
- 使用2010年麦克唐纳标准评估转化为临床确定的MS,包括临床复发和新的脑MRI病变.
主要成果:
- 在199名参与者中,有116人 (58%) 在48周内转化为MS.
- 与安慰剂相比,在未调整的模型中,转换的危险比为0.87 (1000 IU),1.37 (5000 IU) 和1.28 (10 000 IU).
- 在调整后的模型中,危害比为0.80 (1000 IU),1.36 (5000 IU) 和1.07 (10 000 IU),表明没有显著的保护作用.
结论:
- 口服维生素D3补充剂每日剂量高达1万IU并没有减少高风险CIS患者转化为临床确定的多发性硬化症的时间.
- 在这个队列中,维生素D3补充剂被发现是安全的,并且被很好地容忍.
- 该研究没有证明高风险CIS后维生素D3补充剂减少了MS疾病活动.
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