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Effect of vitamin D treatment in ANCA-associated vasculitis: results from an exploratory perspective, pragmatic, non-randomised study
A. Basti1, L. Zgaga2, I. Doubelt3, M. Soowamber4, C. Pagnoux5
- Vasculitis Clinic, Division of Rheumatology, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
- Discipline of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Ireland.
- Vasculitis Clinic, Division of Rheumatology, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
- Vasculitis Clinic, Division of Rheumatology, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
- Vasculitis Clinic, Division of Rheumatology, Mount Sinai Hospital, University of Toronto, Ontario, Canada. christian.pagnoux@sinaihealth.ca
CER19358
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PMID: 41841679 [PubMed]
Received: 26/09/2025
Accepted : 24/11/2025
In Press: 12/03/2026
Abstract
OBJECTIVES:
Vitamin D deficiency has been linked with several autoimmune diseases. Data are limited in anti-neutrophil cytoplasm autoantibody (ANCA)-associated vasculitis (AAV), and it is unknown whether vitamin D could have a therapeutic role in AAV.
METHODS:
The prospective, pragmatic, non-randomised exploratory PRAVDA study with ITT and pre-protocol analyses aimed to enrol >100 patients with AAV at the Vasculitis Clinic (Toronto, Canada) from January to July 2021. 25-hydroxyvitamin D [25(OH)D] was measured at baseline by ELISA. Patients with low 25(OH)D (<75 nmol/L at baseline) were asked to increase vitamin D supplementation by 1000 IU/day (to a maximum 2000 IU/day). 25(OH)D was measured again at month 12. The primary endpoint was 12-month disease relapse. Secondary analyses included correlations between vitamin D status and disease-specific clinical features.
RESULTS:
The study included 101 patients, 41 (40.6%) of whom had low baseline vitamin D levels and were asked to increase vitamin D3 intake. Of these patients, 32 had vitamin D level reassessed at month 12; 62.5% (20/32) had achieved normal levels. Relapse rates at month 12 were similar between patients with low (n=3/41; 7.3%) and normal (n=6/60; 10%; p=0.64) baseline vitamin D levels. However, no relapses were observed in patients who corrected baseline vitamin D deficiency.
CONCLUSIONS:
These findings can help designing larger studies on vitamin D supplementation in AAV patients, focusing mostly on those vitamin D deficient at baseline.
