High-Dose Vitamin D^sub 3^ during Tuberculosis Treatment in Mongolia: A Randomized Controlled Trial

• Published in: American journal of respiratory and critical care medicine Vol. 196; no. 5; p. 628
• Main Authors: Ganmaa, Davaasambuu, Munkhzul, Baatar, Fawzi, Wafaie, Spiegelman, Donna, Willett, Walter C, Bayasgalan, Purev, Baasansuren, Erkhembayar, Buyankhishig, Burneebaatar, Oyun-Erdene, Sereeter, Jolliffe, David A, Xenakis, Theodoros, Bromage, Sabri, Bloom, Barry R, Martineau, Adrian R
• Format: Journal Article
• Language: English
• Published: New York American Thoracic Society 01.09.2017
• Subjects: Clinical trials; Confidence intervals; Dietary supplements; Drug dosages; Evidence-based medicine; Genomes; Microscopy; Tuberculosis; Vitamin D; Vitamin deficiency; Mongolia
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/rccm.201705-0936OC

[...]these trials are variously limited by low prevalence of vitamin D deficiency in the study population at baseline, modest or unmeasured 25(OH)D response to supplementation, significant loss to follow-up, and low statistical power. [...]no trial conducted to date has investigated the influence of mutations in genes other than that encoding the vitamin D receptor (VDR) on responses to vitamin D supplementation in PTB, despite evidence that single nucleotide polymorphisms (SNPs) in other genes in the vitamin D pathway influence disease outcomes (8). Secondary outcomes were the proportion of participants with negative sputum culture at 8 weeks; time from initiation of antituberculous therapy to sputum smear conversion (estimated as the midpoint between the last positive sputum smear and the first negative sputum smear thereafter); mean number of zones affected on chest radiograph at 8 weeks; mean serum concentrations of 25(OH)D, corrected calcium, CRP, and albumin; mean ESR, total white blood cell count, neutrophil count, monocyte count, and lymphocyte:monocyte ratio in peripheral blood; and mean BMI, mid-upper arm circumference, triceps skin-fold thickness, and scapular skin-fold thickness. [...]this large study used a high dose of vitamin D in a population with very low baseline vitamin D status but found no effect of this intervention on time to sputum culture conversion in the study population as a whole. E-mail: gdavaasa@hsph.harvard.edu This article has an online supplement, which is accessible from this issue's table of contents at www.atsjournals.org Am J Respir Crit Care Med Vol 196, Iss 5, pp 628-637, Sep 1, 2017 Copyright © 2017 by the American Thoracic Society Originally Published in Press as DOI: 10.1164/rccm.201705-0936OC on July 10, 2017 Internet address: www.atsjournals.org At a Glance Commentary Scientific Knowledge on the Subject: Existing trials of adjunctive vitamin D in pulmonary tuberculosis treatment are variously limited by small sample sizes, inadequate dosing regimens, and high baseline vitamin D status among participants.