Allergy and Airway: Asthma I |

Can Vitamin D Supplementation in Addition to Asthma Controllers Decrease Asthmatic Exacerbations in Patients With Asthma? A Meta-analysis FREE TO VIEW

Jian Luo; Dan Liu; Chuntao Liu
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West China School of Medicine and West China Hospital, Chengdu, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A12. doi:10.1016/j.chest.2016.02.014
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Acute exacerbations are major causes of morbidity and mortality in patients with asthma, and the effects of vitamin D on acute exacerbation, lung function, fraction of exhaled nitric oxide (FeNO) are still controversial. We aimed to further evaluate the roles of vitamin D supplementation in addition to asthma controllers in asthmatics.

METHODS: Randomized controlled trials which reported rate of asthma exacerbations and adverse events, forced expiratory volume (FEV1, % of predicted value), FeNO, Asthma Control Test (ACT), and serum 25-hydroxyvitamin D levels were identified in Pubmed, Embase, Medline, Cochrane Central Register of Controlled Trials, ISI Web of Science, reference lists and by manual search using ‘Vitamin D’, ‘Vit D’, or ‘VitD’ and ‘asthma’. Random-effects model was applied in the presence of statistical heterogeneity; otherwise fixed-effects model was used. Mann-Whitney U-test was used for hypothesis test, and we set z-value and P-value <0.05 as statistical significance.

RESULTS: Seven trials with a total of 903 patients with asthma were pooled in our final analysis. Except for asthma exacerbations (I2 = 81%, χ2 = 10.28, P = 0.006), we did not find statistical heterogeneity in outcome measures. The pooled risk ratio of asthma exacerbation was 0.66 (95% confidence interval: 0.32∼1.37), but without significant difference (z = 1.12, P = 0.26), neither was in FEV1 (z = 0.30, P = 0.77), FeNO (z = 0.28, P = 0.78), or ACT (z = 0.92, P = 0.36), although serum 25-hydroxyvitamin D was significantly increased (z = 6.16, P < 0.001).

CONCLUSIONS: Vitamin D supplementation in addition to asthma controllers cannot decrease asthma exacerbation and FeNO, nor improve lung function and asthma symptoms, although it can be safely applied to increase serum 25-hydroxyvitamin D levels.

CLINICAL IMPLICATIONS: The illumination of the roles of vitamin D in patients with asthma may have important preventive and therapeutic implications, and may further standardize the treatment of asthma, reduce unnecessary medications, and even help elucidate the mechanisms, which are implicated in pathogenesis and exacerbations of asthma.

DISCLOSURE: The following authors have nothing to disclose: Jian Luo, Dan Liu, Chuntao Liu

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