High-Dose Vitamin D Does Not Prevent Postoperative Recurrence of Crohn’s Disease
Monika Fischer, MD, reviewing de Bruyn JR, et al. Clin Gastroenterol Hepatol 2020 May 24.
The optimal vitamin D level for patients with IBD is highly debated. While a level >20 ng/L is sufficient for bone health even in high-risk individuals, experts recommend a level >30 ng/L for anti-inflammatory effects. Interventional trials with vitamin D, to date, have failed to provide conclusive evidence for this claim.
This multicenter, randomized, controlled trial from Belgium and the Netherlands investigated whether high-dose vitamin D can prevent postoperative recurrence of Crohn’s disease after ileocolonic resection. Patients were assigned to receive either weekly 25,000 IU oral vitamin D (n=72) or placebo (n=71) for 26 weeks. In the vitamin D group, serum levels of 25-hydroxy vitamin D doubled at week 26, increasing from a median of 42 nmol/L (16.8 ng/L) at baseline to 81 nmol/L (32.4 ng/L), but did not reduce endoscopic (modified Rutgeerts score ≥i2b) or clinical recurrence (Crohn’s disease activity index score ≥220) compared to placebo.
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CITATION(S)
de Bruyn JR, Bossuyt P, Ferrante M, et al.; on behalf of the Dutch-Belgian DETECT study group. High-dose vitamin D does not prevent postoperative recurrence of Crohn’s disease in a randomized placebo-controlled trial. Clin Gastroenterol Hepatol 2020 May 24. (Epub ahead of print) (https://doi.org/10.1016/j.cgh.2020.05.037)