Most Read Articles
Rachel Soon, 03 Mar 2020

Military pharmacist Captain Manvikram Singh Gill has become the first medical officer in the Malaysian Armed Forces (MAF) to be honoured with a Southeast Asian award for pharmacy professionals.

Dr. Joseph Delano Fule Robles, 04 Sep 2017

A recent genome-wide association study (GWAS) performed by investigators from the Chinese University of Hong Kong (CUHK) has found potential new indications for existing drugs for the treatment of various psychiatric disorders. 

24 Apr 2017

Helicobacter pylori (H. pylori) infection is associated with conditions such as gastritis, peptic ulcer, gastric cancer, and certain types of lymphoma. A common presenting complaint among all these H. pylori-related illnesses is dyspepsia. Dr Desmond Wai from the Desmond Wai Liver and Gastrointestinal Diseases Centre, Mount Elizabeth Novena Specialist Centre, Singapore, speaks on the important role general practitioners (GPs) play in recognizing, diagnosing, and treating H. pylori.

04 Mar 2020
At 150-mg doses, oral pregabalin appears to be effective for premature ejaculation, increasing intravaginal ejaculation latency time, a recent study has found.

Treating vitamin D deficiency may help prevent COPD attacks

Pearl Toh
16 Feb 2019

Vitamin D supplements can help reduce the rate of moderate-to-severe COPD* exacerbations in patients with inadequate vitamin D levels (<25 nmol/L) at baseline, but not in those with higher levels, according to a meta-analysis of randomized controlled trials (RCTs).  

“Vitamin D supplementation is safe, and it costs just a few pence to supplement a person for a year - so this is a potentially highly cost-effective treatment that could be targeted at those who have low vitamin D levels following routine testing,” suggested principal investigator Professor Adrian Martineau from Queen Mary University of London in London, UK.

The meta-analysis used individual participant data from three double-blind RCTs involving 469 patients with COPD who were randomized to either oral vitamin D3 supplementation or placebo. [Thorax 2019;doi10.1136/thoraxjnl-2018-212092] 

In the overall study population, supplemental vitamin D had no effects on the rate of moderate/severe COPD exacerbations compared with placebo (adjusted incidence rate ratio [aIRR], 0.94; p=0.52).

However, subgroup analysis revealed that supplemental vitamin D benefits patients with baseline 25-hydroxyvitamin D levels <25 nmol/L, who saw the rates of moderate/severe COPD exacerbations significantly reduced by almost half (aIRR, 0.55; p=0.006).

In contrast, the protective effects were not seen in the patient subgroup whose baseline 25-hydroxyvitamin D [25(OH)D] levels were 25 nmol/L (aIRR, 1.04; p=0.71).

“Our study shows that giving supplements to vitamin D-deficient COPD patients nearly halves their rate of potentially fatal attacks,” said Martineau.

“Given the high prevalence of profound vitamin D deficiency in people with COPD, and the large reduction in exacerbation rates seen with vitamin D supplementation in [the subgroup with low baseline 25(OH)D], our findings support a strategy of routinely testing vitamin D status in patients with COPD who experience exacerbations and offering supplementation to [these patients],” the researchers stated.

There was no effect on COPD exacerbations with vitamin D supplementation when the analyses were prespecified by other factors such as baseline GOLD spirometric grade, BMI, concomitant use of inhaled corticosteroids, polymorphisms in genes involved in vitamin D metabolism (VDR and DBP), and the frequency of vitamin D dosing.

The proportion of patients who had at least one serious adverse event also did not change with vitamin D supplementation (adjusted odds ratio, 1.16, 95 percent confidence interval, 0.76–1.75), which according to the researchers, indicates that “vitamin D supplementation was safe at the doses administered.”

“Serious adverse events and occasional episodes of hypercalcaemia were evenly distributed between participants randomized to vitamin D versus placebo, and no instances of renal stones were seen,” they noted.

The findings echoed the results from previous studies by the same research team, which showed that vitamin D supplementation was protective against asthma attacks and acute respiratory infections in people with low baseline vitamin D levels. [BMJ 2017;356:i6583; Lancet Respir Med 2017;5:881-890]

“Since acute respiratory infections commonly precipitate exacerbations of both asthma and COPD, it may be that protective effects of vitamin D against these outcomes are mediated by a common mechanism, namely induction of antiviral and antimicrobial responses,” suggested Martineau and co-authors on the potential mechanism behind the protective effects of vitamin D. 

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Pharmacist - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Rachel Soon, 03 Mar 2020

Military pharmacist Captain Manvikram Singh Gill has become the first medical officer in the Malaysian Armed Forces (MAF) to be honoured with a Southeast Asian award for pharmacy professionals.

Dr. Joseph Delano Fule Robles, 04 Sep 2017

A recent genome-wide association study (GWAS) performed by investigators from the Chinese University of Hong Kong (CUHK) has found potential new indications for existing drugs for the treatment of various psychiatric disorders. 

24 Apr 2017

Helicobacter pylori (H. pylori) infection is associated with conditions such as gastritis, peptic ulcer, gastric cancer, and certain types of lymphoma. A common presenting complaint among all these H. pylori-related illnesses is dyspepsia. Dr Desmond Wai from the Desmond Wai Liver and Gastrointestinal Diseases Centre, Mount Elizabeth Novena Specialist Centre, Singapore, speaks on the important role general practitioners (GPs) play in recognizing, diagnosing, and treating H. pylori.

04 Mar 2020
At 150-mg doses, oral pregabalin appears to be effective for premature ejaculation, increasing intravaginal ejaculation latency time, a recent study has found.