Reviews
Is cholecalciferol a potential disease-modifying anti-rheumatic drug for the management of rheumatoid arthritis?
M. Bellan1, L. Andreoli2, A. Nerviani3, S. Piantoni4, G.C. Avanzi5, D. Soddu6, E. Hayden7, M. Pirisi8, P.P. Sainaghi9
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara; Division of Internal Medicine, Immuno-Rheumatology Unit, CAAD (Center for Translational Research on Autoimmune and Allergic Disease) “Maggiore della Carità” Hospital, Novara; and IRCAD, Interdisciplinary Research Center of Autoimmune Diseases, Novara, Italy. mattia.bellan@med.uniupo.it
- Rheumatology and Clinical Immunology Unit and Department of Clinical and Experimental Sciences, Spedali Civili and University of Brescia, Italy.
- IRCAD, Interdisciplinary Research Center of Autoimmune Diseases, Novara, Italy; and Centre for Experimental Medicine and Rheumatology, Barts and The London School of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, UK.
- Rheumatology and Clinical Immunology Unit and Department of Clinical and Experimental Sciences, Spedali Civili and University of Brescia, Italy.
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, and Emergency Medicine Department, “Maggiore della Carità” Hospital, Novara, Italy.
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara; and Division of Internal Medicine, Immuno-Rheumatology Unit, CAAD (Center for Translational Research on Autoimmune and Allergic Disease) “Maggiore della Carità” Hospital, Novara, Italy.
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara; and Division of Internal Medicine, Immuno-Rheumatology Unit, CAAD (Center for Translational Research on Autoimmune and Allergic Disease) “Maggiore della Carità” Hospital, Novara, Italy.
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara; Division of Internal Medicine, Immuno-Rheumatology Unit, CAAD (Center for Translational Research on Autoimmune and Allergic Disease) “Maggiore della Carità” Hospital, Novara; and IRCAD, Interdisciplinary Research Center of Autoimmune Diseases, Novara, Italy.
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara; Division of Internal Medicine, Immuno-Rheumatology Unit, CAAD (Center for Translational Research on Autoimmune and Allergic Disease) “Maggiore della Carità” Hospital, Novara; and IRCAD, Interdisciplinary Research Center of Autoimmune Diseases, Novara, Italy.
CER12189
2020 Vol.38, N°2
PI 0343, PF 0349
Reviews
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PMID: 31573472 [PubMed]
Received: 23/02/2019
Accepted : 01/07/2019
In Press: 17/09/2019
Published: 26/03/2020
Abstract
Vitamin D is a pleiotropic molecule with a well-characterised immunomodulatory activity in vitro; however, its potential clinical application in autoimmune conditions has yet to be clarified. Several authors have investigated the use of vitamin D as a disease-modifying anti-rheumatic drug (DMARD) in rheumatoid arthritis (RA), obtaining divergent conclusions. This systematic review summarises and critically analyses the findings of papers assessing the impact of vitamin D supplementation on pain relief, disease activity, functional status and flare rate. We conclude that the correction of hypovitaminosis D may have a beneficial effect on pain perception; moreover, the achievement of an adequate plasma vitamin D concentration obtained with high-dose regimens might evoke immunomodulatory activities of vitamin D and favourably impact on disease control. Nevertheless, the current evidence is still not strong enough to support the use of cholecalciferol as a DMARD in RA, and further studies are required to clarify this issue.