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Metaanálisis2019Financiado por la industriaAcceso abierto

Financiado en parte por Vifor Pharma

Vitamin D supplementation to prevent acute respiratory infections: individual participant data meta-analysis

Martineau AR, Jolliffe DA, Greenberg L, Aloia JF, Bergman P, Dubnov-Raz G, Esposito S, Ganmaa D, Ginde AA, Goodall EC, Grant CC, Janssens W, Jensen ME, Kerley CP, Laaksi I, Manaseki-Holland S, Mauger D, Murdoch DR, Neale R, Rees JR, Simpson S, Stelmach I, Trilok Kumar G, Urashima M, Camargo CA, Griffiths CJ, Hooper RL

Health technology assessment (Winchester, England) · 200 citas

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Financiado por la industria

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Cómo se estudió

Diseño
Metaanálisis (indexado por PubMed)
Estudiado en
Personas
Resultado principal
Eventos clínicos como enfermedad o muerte

Quién lo pagó

Financiación
Financiado por la industria
Universidad u hospital
Dartmouth College
Gobierno
National Institute for Health and Care Research
Gobierno
Department of Health and Social Care
Universidad u hospital
University of Southampton
Empresa
Vifor Pharma
Gobierno
Vlaamse regering
Gobierno
National Institutes of Health
Gobierno
Medical Research Council
Gobierno
Health Technology Assessment Programme
Gobierno
Health Services and Delivery Research Programme
Gobierno
Programme Grants for Applied Research
Gobierno
National Heart, Lung, and Blood Institute
Gobierno
NHLBI NIH HHS
Gobierno
National Institute for Health Research (NIHR)
Subvenciones
National Heart, Lung, and Blood Institute (U10 HL064313); Health Technology Assessment Programme (13/03/25); National Heart, Lung, and Blood Institute (U10 HL098115); National Institute for Health and Care Research (13/03/25); National Institute for Health and Care Research (HTA/13/03/25)

Según 14 financiadores declarados.

Publicación

Publicado
2019-01-01 · Health Technol Assess · vol. 23 · número 2 · págs. 1–44
Editorial
NIHR Journals Library
Citado
367 citas · más que el 100% de estudios similares · 13.3× el promedio de su campo
Impacto
Entre el 10 % más citado de su campo
Referencias
72 trabajos
Acceso
Acceso abierto (publicación gratuita) · CC-BY
Áreas de investigación
Vitamin D Research Studies · Vitamin C and Antioxidants Research · Chronic Obstructive Pulmonary Disease (COPD) Research
Palabras clave
Medicine, Meta-analysis, Placebo, Blinding, Odds ratio, Confidence interval, Internal medicine, Randomized controlled trial, Number needed to treat, Relative risk, Subgroup analysis, Alternative medicine
MeSH
humans, respiratory tract infections, vitamin d deficiency, cholecalciferol, ergocalciferols, vitamin d, influenza vaccines, body mass index, drug administration schedule, double-blind method, age factors, comorbidity, dose-response relationship, drug, dietary supplements, adolescent, adult, aged, aged, 80 and over, middle aged, child, child, preschool, infant, female, male, randomized controlled trials as topic, young adult

27 autores

  • Adrian R. Martineau🇬🇧Queen Mary University of London; Asthma UK; Blizard Institute
  • David A. Jolliffe🇬🇧Queen Mary University of London
  • Lauren Greenberg🇬🇧Queen Mary University of London
  • John F. Aloia🇺🇸Winthrop-University Hospital
  • Peter Bergman🇸🇪Karolinska Institutet
  • Gal Dubnov‐Raz🇮🇱Edmond and Lily Safra Children's Hospital
  • Susanna Esposito🇮🇹University of Milan; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
  • Davaasambuu Ganmaa🇺🇸Harvard University
  • Adit A. Ginde🇺🇸University of Colorado Denver
  • Emma C Goodall🇨🇦McMaster University
  • Cameron Charles Grant🇳🇿University of Auckland
  • Wim Janssens🇧🇪Universitair Ziekenhuis Leuven
  • Megan E. Jensen🇦🇺University of Newcastle Australia
  • Conor P. Kerley🇮🇪Dublin City University
  • Ilkka Laaksi🇫🇮Finnish Defence Forces; Tampere University
  • Semira Manaseki‐Holland🇬🇧University of Birmingham
  • David T. Mauger🇺🇸Pennsylvania State University
  • David R. Murdoch🇳🇿University of Otago
  • Rachel E. Neale🇦🇺QIMR Berghofer Medical Research Institute
  • Judy R. Rees🇺🇸Dartmouth College
  • Steve Simpson🇦🇺University of Tasmania
  • Iwona Stelmach🇵🇱Medical University of Lodz
  • Geeta Trilok Kumar🇮🇳University of Delhi
  • Mitsuyoshi Urashima🇯🇵Jikei University School of Medicine
  • Carlos A. Camargo🇺🇸Harvard University; Massachusetts General Hospital
  • Chris Griffiths🇬🇧Queen Mary University of London; Asthma UK; Blizard Institute; Medical Research Council
  • Richard Hooper🇬🇧Queen Mary University of London

Resumen

El texto original del estudio, en el idioma en que se publicó.

Background

Randomised controlled trials (RCTs) exploring the potential of vitamin D to prevent acute respiratory infections have yielded mixed results. Individual participant data (IPD) meta-analysis has the potential to identify factors that may explain this heterogeneity.

Objectives

To assess the overall effect of vitamin D supplementation on the risk of acute respiratory infections (ARIs) and to identify factors modifying this effect.

Data sources

MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, ClinicalTrials.gov and the International Standard Randomised Controlled Trials Number (ISRCTN) registry.

Study selection

Randomised, double-blind, placebo-controlled trials of supplementation with vitamin D3 or vitamin D2 of any duration having incidence of acute respiratory infection as a prespecified efficacy outcome were selected.

Study appraisal

Study quality was assessed using the Cochrane Collaboration Risk of Bias tool to assess sequence generation, allocation concealment, blinding of participants, personnel and outcome assessors, completeness of outcome data, evidence of selective outcome reporting and other potential threats to validity.

Results

We identified 25 eligible RCTs (a total of 11,321 participants, aged from 0 to 95 years). IPD were obtained for 10,933 out of 11,321 (96.6%) participants. Vitamin D supplementation reduced the risk of ARI among all participants [adjusted odds ratio (aOR) 0.88, 95% confidence interval (CI) 0.81 to 0.96; heterogeneity p p = 0.05). Among those receiving daily or weekly vitamin D, protective effects of vitamin D were stronger in individuals with a baseline 25-hydroxyvitamin D [25(OH)D] concentration of p = 0.006). Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event (aOR 0.98, 95% CI 0.80 to 1.20; p = 0.83). The body of evidence contributing to these analyses was assessed as being of high quality.

Limitations

Our study had limited power to detect the effects of vitamin D supplementation on the risk of upper versus lower respiratory infection, analysed separately.

Conclusions

Vitamin D supplementation was safe, and it protected against ARIs overall. Very deficient individuals and those not receiving bolus doses experienced the benefit. Incorporation of additional IPD from ongoing trials in the field has the potential to increase statistical power for analyses of secondary outcomes.

Study registration

This study is registered as PROSPERO CRD42014013953.

Funding

The National Institute for Health Research Health Technology Assessment programme.

Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.

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