Vitamin D to prevent exacerbations of COPD: systematic review and meta-analysis of individual participant data from randomised controlled trials
Jolliffe DA, Greenberg L, Hooper RL, Mathyssen C, Rafiq R, de Jongh RT, Camargo CA, Griffiths CJ, Janssens W, Martineau AR
Thorax · 141 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Institute for Health and Care Research
- Gobierno
- Health Technology Assessment Programme
- Gobierno
- National Institute for Health Research (NIHR)
- Subvenciones
- National Institute for Health and Care Research (13/03/25); National Institute for Health and Care Research (HTA/13/03/25)
Según 3 financiadores declarados.
Publicación
- Publicado
- 2019-01-10 · Thorax · vol. 74 · número 4 · págs. 337–345
- Editorial
- BMJ
- Citado
- 198 citas · más que el 98% de estudios similares · 6.3× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 26 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Vitamin D Research Studies · Chronic Obstructive Pulmonary Disease (COPD) Research · Asthma and respiratory diseases
- Palabras clave
- vitamin D supplementation, chronic obstructive pulmonary disease, COPD exacerbations, 25-hydroxyvitamin D, subgroup analysis, adverse events
- MeSH
- humans, pulmonary disease, chronic obstructive, vitamin d deficiency, vitamin d, dietary supplements, randomized controlled trials as topic
10 autores
- David A. Jolliffe🇬🇧University of London; Queen Mary University of London
- Lauren Greenberg🇬🇧University of London; Queen Mary University of London
- Richard Hooper🇬🇧University of London; Queen Mary University of London
- Carolien Mathyssen🇧🇪KU Leuven
- Rachida Rafiq🇳🇱Amsterdam UMC Location Vrije Universiteit Amsterdam
- Renate T. de Jongh🇳🇱Amsterdam UMC Location Vrije Universiteit Amsterdam
- Carlos A. Camargo🇺🇸Harvard University; Massachusetts General Hospital
- Chris Griffiths🇬🇧University of London; Queen Mary University of London; Blizard Institute
- Wim Janssens🇧🇪KU Leuven
- Adrian R. Martineau🇬🇧 · autor de correspondenciaUniversity of London; Queen Mary University of London; Blizard Institute
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Randomised controlled trials (RCTs) of vitamin D to prevent COPD exacerbations have yielded conflicting results.Individual participant data meta-analysis could identify factors that explain this variation.
Methods
PubMed, Embase, the Cochrane Central Register of Controlled Trials and Web of Science were searched from inception up to and including 5 October 2017 to identify RCTs of vitamin D supplementation in patients with COPD that reported incidence of acute exacerbations. Individual participant data meta-analysis was performed using fixed effects models adjusting for age, sex, Global Initiative for Chronic Obstructive Lung Disease spirometric grade and trial.
Results
Four eligible RCTs (total 560 participants) were identified; individual participant data were obtained for 469/472 (99.4%) participants in three RCTs. Supplementation did not influence overall rate of moderate/severe COPD exacerbations (adjusted incidence rate ratio (aIRR) 0.94, 95% CI 0.78 to 1.13). Prespecified subgroup analysis revealed that protective effects were seen in participants with baseline 25-hydroxyvitamin D levels <25 nmol/L (aIRR 0.55, 95% CI 0.36 to 0.84) but not in those with baseline 25-hydroxyvitamin D levels ≥25 nmol/L (aIRR 1.04, 95% CI 0.85 to 1.27; p for interaction=0.015). Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event (adjusted OR 1.16, 95% CI 0.76 to 1.75).
Conclusions
Vitamin D supplementation safely and substantially reduced the rate of moderate/severe COPD exacerbations in patients with baseline 25-hydroxyvitamin D levels <25 nmol/L but not in those with higher levels.
Trial registration number
CRD42014013953.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
Confianza de la comunidad
Cargando…
¿Cuánto confías en los hallazgos de este estudio?
Comentarios
¿Algo está mal aquí?
Señala este estudio si su información, etiquetas o financiación parecen incorrectas. Un editor revisa cada señalamiento.
Información educativa sobre investigación publicada. No es consejo médico ni una recomendación para empezar o dejar nada.