HealthDay News — Vitamin D supplementation safely and substantially reduces the rate of moderate-to-severe chronic obstructive pulmonary disease (COPD) exacerbations in patients with baseline 25-hydroxyvitamin D levels <25 nmol/L, according to a review published online Jan. 10 in Thorax.

David A. Jolliffe, PhD, from the University of London, and colleagues conducted a systematic literature review to identify randomized controlled trials (RCTs) of vitamin D supplementation in patients with COPD who reported incidence of acute exacerbations.

Based on 4 included studies (total of 560 patients), the researchers found that supplementation did not influence the overall rate of moderate-to-severe COPD exacerbations (adjusted incidence rate ratio [aIRR], 0.94; 95% confidence interval [CI], 0.78 to 1.13). In participants with baseline 25-hydroxyvitamin D levels <25 nmol/L, protective effects were seen (aIRR, 0.55; 95% CI, 0.36 to 0.84), but these effects were not observed in patients with baseline 25-hydroxyvitamin D levels ≥25 nmol/L (aIRR, 1.04; 95% CI, 0.85 to 1.27; P for interaction = 0.015). There were no significant differences by vitamin D level seen in the proportion of participants experiencing at least one serious adverse event (adjusted odds ratio, 1.16; 95% CI, 0.76 to 1.75).

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“Our findings support a strategy of routinely testing vitamin D status in patients with COPD who experience exacerbations and offering supplementation to those with circulating 25(OH)D concentrations of less than 25 nmol/L,” the authors write.

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