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Vitamin D for the management of asthma: Cochrane systematic review and meta-analysis

Adrian R. Martineau, Christopher J. Cates, Mitsuyoshi Urashima, Megan Jensen, Alex P. Griffiths, Ulugbek Nurmatov, Aziz Sheikh, Christopher J. Griffiths
European Respiratory Journal 2016 48: PA4112; DOI: 10.1183/13993003.congress-2016.PA4112
Adrian R. Martineau
1Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
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Christopher J. Cates
2Population Health Research Institute, St George's, University of London, London, United Kingdom
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Mitsuyoshi Urashima
3Division of Molecular Epidemiology, Jikei University School of Medicine, Tokyo, Japan
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Megan Jensen
4Centre for Asthma and Respiratory Diseases, University of Newcastle, Newcastle, Australia
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Alex P. Griffiths
1Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
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Ulugbek Nurmatov
5Asthma UK Centre for Applied Research, University of Edinburgh, Edinburgh, United Kingdom
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Aziz Sheikh
5Asthma UK Centre for Applied Research, University of Edinburgh, Edinburgh, United Kingdom
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Christopher J. Griffiths
1Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
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Abstract

Background: Several clinical trials of vitamin D to reduce risk of asthma exacerbation and improve asthma control have been conducted in children and adults, but a meta-analysis restricted to double-blind randomised placebo-controlled trials of this intervention is lacking.

Objectives: To evaluate the efficacy of administration of vitamin D in reducing asthma exacerbations treated with systemic corticosteroids (primary outcome) and improving asthma symptom control.

Methods: Standard Cochrane Collaboration procedures were followed. Double-blind randomised placebo-controlled trials of vitamin D in children and adults with asthma evaluating exacerbation risk and/or asthma symptom control were included.

Results: Seven trials involving a total of 435 children and two trials involving a total of 658 adults were included in the primary analysis. Administration of vitamin D reduced the rate of exacerbations requiring systemic corticosteroids (Rate Ratio 0.63, 95% CI 0.45 to 0.88; 680 participants; 3 studies), and decreased the risk of having at least one exacerbation requiring an emergency department visit and/or hospitalisation (Odds Ratio [OR] 0.39, 95% CI 0.19 to 0.78; 963 participants; 7 studies). Sub-group analysis to determine whether the effect of vitamin D on risk of severe exacerbation was modified by baseline vitamin D status was not performed, due to unavailability of suitably disaggregated data.

Conclusions: Vitamin D is likely to prevent severe asthma exacerbation and reduce health care use by people with asthma. It is not yet clear whether these effects are confined to people with lower baseline vitamin D status. Further research is needed before definitive clinical recommendations can be made.

  • Asthma - management
  • Exacerbation
  • Treatments
  • Copyright ©the authors 2016
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Vitamin D for the management of asthma: Cochrane systematic review and meta-analysis
Adrian R. Martineau, Christopher J. Cates, Mitsuyoshi Urashima, Megan Jensen, Alex P. Griffiths, Ulugbek Nurmatov, Aziz Sheikh, Christopher J. Griffiths
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4112; DOI: 10.1183/13993003.congress-2016.PA4112

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Vitamin D for the management of asthma: Cochrane systematic review and meta-analysis
Adrian R. Martineau, Christopher J. Cates, Mitsuyoshi Urashima, Megan Jensen, Alex P. Griffiths, Ulugbek Nurmatov, Aziz Sheikh, Christopher J. Griffiths
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4112; DOI: 10.1183/13993003.congress-2016.PA4112
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