20 December 2014

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

Purchase this articleRheumatology Article

J. Baker, D. Baker, G. Toedter, J. Shults, J. Von Feldt, M. Leonard

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

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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 1885 years, enrolled in a randomised clinical trial of golimumab (Go-Before Trial). Subjects were methotrexate and biologic therapy nave. 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 [0.591.40]).
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

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