Vitamin D levels may influence response to treatment with anti-TNFα medications in patients with inflammatory bowel disease (IBD), according to new research that also linked low vitamin D to reduced risk of IBD remission.
The research paper, “Higher 25-hydroxyvitamin D Levels Are Associated With Greater Odds Of Remission With Anti-Tumour Necrosis Factor-A Medications Among Patients With Inflammatory Bowel Diseases,” was published in the journal Alimentary Pharmacology and Therapeutics.
Previous studies have shown that vitamin D deficiency is associated with IBD disease activity and may prolong the duration of therapy with anti-TNFα (an inflammatory protein) medications among IBD patients.
To understand whether levels of vitamin D also could influence remission, researchers analyzed the medical records of 173 IBD patients from the Brigham and Women’s Hospital IBD Center database. Patients included in the study had vitamin D levels drawn within six months prior, or two weeks after, initiation of anti-TNFα therapy (infliximab or adalimumab) and had IBD remission at three months.
The team observed that 122 patients had normal vitamin D levels, whereas 51 had low levels when they started anti-TNFα therapy. Results indicated that vitamin D levels were associated with remission after three months of therapy. Patients with lower vitamin D levels had lower risk of remission at this period compared to the other group, regardless of age, gender, diagnosis, type of anti-TNFα therapy, and first or subsequent anti-TNFα treatment received.
“These results show a significant association between vitamin D levels and rates of remission among patients with IBD,” researchers wrote. “Specifically, patients who had low vitamin D levels prior to treatment had decreased odds of being in remission after three months of treatment with anti-TNFα therapy.”
“These findings may have clinical implications as we have shown that vitamin D levels are associated with initial response to TNFα therapy,” they added. “… larger studies investigating remission rates among patients with low vitamin D levels are warranted. If our findings are confirmed in larger studies, recommendations for clinical management of IBD may include therapy with vitamin D. Further study regarding optimal timing and dosing of vitamin D supplementation should be clarified in future investigations,” the researchers recommended.