Study: Vitamin D supplementation can be helpful in chronic urticaria

roror A, Goldner B, Lyden MS, Poole yes. Advantageous role in a supplementary vitamin D3 treatment in chronic urticaria: a randomized study. All asthma immunol. 2014; EPUB before printing.

Design

single center, prospective, randomized, double-blind study with 2 arms. The participants in ARM 1 were given 4,000 IE vitamin d orally. Participants in ARM 2 received 600 IE per day. The duration of the studies was 12 weeks and all participants used the standard ripening therapy (certricine, ranitidine, montelukast) as required.

participant

42 participants took part in the study who had suffered from idiopathic urticaria and/or idiopathic angioedema for at least 6 weeks. The exclusion criteria included physical urticaria (known physical trigger), hereditary or acquired angioedema, hypercalcemia, renal failure, primary hyperparathyroidism, sarcoidosis, granulomatous illness, malignancy or pregnancy/lactation.

study parameters

medication, severity of urticaria

primary result dimensions

urtikaria-heavy degree score (USS). Number and type of medication used (H1, H2 receptor antagonists, leukotria antagonists)

most important knowledge

The triple therapy led to a significant relief of the symptoms within a week and lowered the total-off values ​​in both arms by 33 %. The addition of 4,000 IE/day vitamin D was safe and ensured additional relief of the symptoms, with a reduction in the entire USS values ​​by 40 % after 12 weeks. The arm with high-dose vitamin D showed a trend ( p = 0.052) in the direction of lower USS values ​​compared to the group with a low dose in week 12, with a lower urticaria base distribution and a few days with hives. In addition, the participants reported better sleep and less severe itching in the group with a high dose compared to the group with low dose. While the serum levels of 25 hydroxycholecalciferol were generally higher in the high dose group, there was no direct connection with the vitamin D mirror and the improvement in symptoms (USS scores). The use of allergic medication does not differ between the groups.

effects on practice

Vitamin D deficiency is associated with asthma and atopic diseases. However, the existing clinical data are full of contradictory reports. ^{3.4 At the moment there is no sufficient data on the possible cause of a D defect and the clinical value of a vitamin D supplementation for certain allergic and atopic health conditions.}

This is the first RCT for chronic, idiopathic urticaria. In this study, the final USS values ​​of 24.1 (4.0) with the low dose and 15.0 (2.9) only indicate that they are significant ( p = 0.052) The study has two essential restrictions: 1) The sample size was small and 2) The middle 25 (oh) D values ​​were in the low dose group (37 ng/ml) significantly higher than in the high dose group group (29 ng/ml) at the beginning. At the end of the study, the low -dose group remained unchanged and the high -dose group rose to an average of 56 ng/ml.

A value of 37 ng/ml (basic average of the low dose group) with a small standard deviation is considered a population saturated with vitamin D. This is a structure for a classic false-negative study of type II. That means that the addition of a group with normal values ​​may not lead to an improvement. The unsurpassed serum level at the beginning of the study spoke for a negative study. This problem could be solved if the study had taken longer or the participants had been divided into suitable arms accordingly.

This study definitely supports triple therapy for relieving patients. This study suggests that the addition of 4,000 IE vitamin D can bring additional relief. The results are not Homerun. Doctors can achieve significant additional relief if they concentrate on the intestinal function and unwanted food reactions.