Associations between vitamin D, disease activity, and clinical response to therapy in rheumatoid arthritis

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Department of Medicine, Division of Rheumatology, University of Pennsylvania, Philadelphia, USA. bakerjo@uphs.upenn.edu

CER5109 Submission on line
2012 Vol.30, N°5 - PI 0658, PF 0664
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Rheumatology Article



Vitamin D deficiency is a potential risk factor for autoimmunity. Prior studies of the association between vitamin D levels and rheumatoid arthritis (RA) disease activity have yielded conflicting results.
Serum 25(OH)vitamin D levels were measured at baseline in 499 participants with active RA, ages 18–85 years, enrolled in a randomised clinical trial of golimumab (Go-Before Trial). Subjects were methotrexate and biologic therapy naïve. Multivariable linear regression was used to assess associations between vitamin D levels and disease activity scores (DAS28), van der Heijde-Sharp (vdHS) erosion scores, and serum inflammatory markers. Generalised estimating equations were used to evaluate the associations between vitamin D status and the response to therapy over 52 weeks, using the DAS28 and ACR response.
Forty-eight percent of participants were vitamin D deficient, defined as serum 25(OH)vitamin D <20 ng/mL. Deficiency was not associated with greater DAS28 (β-0.021 [95% CI -0.22, 0.18]), adjusted for age, race, sex, BMI, disease duration and glomerular filtration rate. Vitamin D deficiency was not associated with baseline vdHS scores or inflammatory markers in adjusted or unadjusted models. There was no association between baseline vitamin D deficiency and change in DAS28 (β = -0.024 [-0.30, 0.25]), proportion meeting ACR response (OR 0.82 [0.56, 1.20]), or radiographic progression at 52 weeks (OR 0.91 [0.59–1.40]).
Vitamin D levels were not associated with RA disease activity, inflammatory markers, or vdHS scores at baseline. Furthermore, there was no association between baseline vitamin D level and response to therapy or radiographic progression.

PMID: 22776409 [PubMed]

Received: 20/09/2011 - Accepted : 28/11/2011 - In Press: 17/10/2012 - Published: 17/10/2012