Higher 25‐hydroxyvitamin D levels are associated with greater odds of remission with anti‐tumour necrosis factor‐α medications among patients with inflammatory …

RW Winter, E Collins, B Cao… - Alimentary …, 2017 - Wiley Online Library
RW Winter, E Collins, B Cao, M Carrellas, AM Crowell, JR Korzenik
Alimentary pharmacology & therapeutics, 2017Wiley Online Library
Background Vitamin D has been linked to disease activity among patients with inflammatory
bowel diseases (IBD). Prior investigation has also suggested that vitamin D levels may affect
duration of therapy with anti‐tumour necrosis factor‐α (anti‐TNF‐α) medications among
patients with IBD. Aim To evaluate the relationship between vitamin D levels and odds of
reaching remission while on an anti‐TNF‐α medication. Methods A total of 521 IBD patients
enrolled in the Brigham and Women's IBD Centre database were eligible for inclusion …
Background
Vitamin D has been linked to disease activity among patients with inflammatory bowel diseases (IBD). Prior investigation has also suggested that vitamin D levels may affect duration of therapy with anti‐tumour necrosis factor‐α (anti‐TNF‐α) medications among patients with IBD.
Aim
To evaluate the relationship between vitamin D levels and odds of reaching remission while on an anti‐TNF‐α medication.
Methods
A total of 521 IBD patients enrolled in the Brigham and Women's IBD Centre database were eligible for inclusion. Patients treated with anti‐TNF‐α therapy who had vitamin D levels drawn within 6 months prior or 2 weeks after initiation of anti‐TNF‐α medication and who had reported remission status at 3 months were included. A logistic regression model adjusting for age, gender, IBD diagnosis, anti‐TNF‐α medication (infliximab vs. adalimumab) and first or subsequent anti‐TNF‐α medication was used to identify the effect of vitamin D level on initial response to anti‐TNF‐α therapy.
Results
A total of 173 patients were included in the final analysis. On logistic regression, patients with normal vitamin D levels n = 122 at the time of anti‐TNF‐α medication initiation had a 2.64 increased odds of remission at 3 months compared to patients with low vitamin D levels n = 51 when controlling for age, gender, diagnosis, type of anti‐TNF‐α medication and first or subsequent anti‐TNF‐α medication (OR = 2.64, 95% CI = 1.31–5.32, P = 0.0067).
Conclusions
These findings suggest that vitamin D levels may influence initial response to anti‐TNF‐α medication and that low vitamin D levels may pre‐dispose patients to decreased odds of remission.
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