Vitamin D 3 as an add-on treatment for multiple sclerosis: A systematic review and meta-analysis of randomized controlled trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 38211504 · doi:10.1016/j.msard.2024.105433
What was done
Authors searched PubMed, Embase, and Cochrane Library through December 18, 2022, for randomized controlled trials evaluating high-dose cholecalciferol (vitamin D3, 1,000 IU/day or more) as an add-on therapy in patients with multiple sclerosis. Study selection, data extraction, and risk of bias assessments were performed independently. Meta-analyses were conducted for Expanded Disability Status Scale (EDSS) score at last follow-up, annualized relapse rate (ARR), and new T2 lesion count.
What was found
Nine studies with 867 participants were included. High-dose vitamin D3 supplementation showed no statistically significant reduction in EDSS (MD = 0.02, 95% CI [-0.37, 0.41], p = 0.91), ARR (MD = -0.03, 95% CI [-0.08, 0.02], p = 0.26), or new T2 lesions (MD = -0.59, 95% CI [-1.24, 0.07], p = 0.08) at 6 to 24 months. No evidence of publication bias was found.
Why it matters
Despite observational links between vitamin D deficiency and multiple sclerosis progression, pooled trial evidence indicates that high-dose vitamin D3 add-on therapy provides no measurable benefit on clinical relapse rates or disability progression.
Limits
The total sample size was modest (867 participants across 9 trials), and follow-up was limited to 6 to 24 months. The abstract does not report baseline vitamin D levels, concurrent disease-modifying therapies, specific dosing differences across trials, or adverse event data.
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