Comments on the use of vitamin D in clinical practice, pros and cons
ECTRIMS Online Library. Mowry E. 09/11/19; 279381; 29
Ellen Mowry
Ellen Mowry
Contributions
Abstract

Abstract: 29

Type: Hot Topic

Abstract Category: Hot Topic 3: Should we recommend vitamin D supplementation to our MS

E. Mowry

Neurology, Johns Hopkins University, Baltimore, MD, United States

Since it was reported that people who eventually developed multiple sclerosis (MS) had lower levels of serum 25-hydroxyvitamin D several years prior to the first definitive clinical MS symptoms, there has been substantial interest in how the results may apply to those already diagnosed with the condition. Indeed, despite the lack of randomized controlled trial data supporting its use, supplementation with oral vitamin D, to various target serum levels, has for several years been considered by most neurologists a cornerstone of complementary therapy for people with MS. This practice change was fueled in part by observational studies demonstrating associations between 25-hydroxyvitamin D levels and subsequent MS clinical outcomes, such as relapses and new MRI lesions. However, some more recent publications suggest that the role of vitamin D in MS susceptibility and prognosis may be more complex than it originally seemed, and MS randomized controlled trial data thus far have not shown a striking benefit of vitamin D supplementation with respect to primary trial outcomes. While these short trials have fortunately not shown major safety concerns in study participants, the safety of vitamin D supplementation in the broader population of people with MS, in which comorbidities that may have served as exclusion factors in the clinical trials may be more common, is not established. Further, whether long-term vitamin D supplementation is associated with any adverse health consequences for people with MS has not been studied. In this presentation, data supporting and refuting the routine use of vitamin D supplementation among people with MS will be discussed.
Disclosure: Dr. Mowry receives research grant funding from Genzyme and Biogen for investigator-initiated studies. She receives free medication for an investigator-initiated clinical trial, of which she is PI, from Teva. She has been site PI of studies sponsored by Biogen and Sun Pharma. She receives royalties for editorial duties from UpToDate.

Abstract: 29

Type: Hot Topic

Abstract Category: Hot Topic 3: Should we recommend vitamin D supplementation to our MS

E. Mowry

Neurology, Johns Hopkins University, Baltimore, MD, United States

Since it was reported that people who eventually developed multiple sclerosis (MS) had lower levels of serum 25-hydroxyvitamin D several years prior to the first definitive clinical MS symptoms, there has been substantial interest in how the results may apply to those already diagnosed with the condition. Indeed, despite the lack of randomized controlled trial data supporting its use, supplementation with oral vitamin D, to various target serum levels, has for several years been considered by most neurologists a cornerstone of complementary therapy for people with MS. This practice change was fueled in part by observational studies demonstrating associations between 25-hydroxyvitamin D levels and subsequent MS clinical outcomes, such as relapses and new MRI lesions. However, some more recent publications suggest that the role of vitamin D in MS susceptibility and prognosis may be more complex than it originally seemed, and MS randomized controlled trial data thus far have not shown a striking benefit of vitamin D supplementation with respect to primary trial outcomes. While these short trials have fortunately not shown major safety concerns in study participants, the safety of vitamin D supplementation in the broader population of people with MS, in which comorbidities that may have served as exclusion factors in the clinical trials may be more common, is not established. Further, whether long-term vitamin D supplementation is associated with any adverse health consequences for people with MS has not been studied. In this presentation, data supporting and refuting the routine use of vitamin D supplementation among people with MS will be discussed.
Disclosure: Dr. Mowry receives research grant funding from Genzyme and Biogen for investigator-initiated studies. She receives free medication for an investigator-initiated clinical trial, of which she is PI, from Teva. She has been site PI of studies sponsored by Biogen and Sun Pharma. She receives royalties for editorial duties from UpToDate.

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