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Home All Specialties Chronic Disease

The VIDA trial: Vitamin D3 does not improve outcomes in asthma patients

byReshmi MadankumarandPriyanka Vedak
May 18, 2014
in Chronic Disease, Pulmonology
Reading Time: 2 mins read
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Image: PD 

1. Supplementation of ciclesonide with Vitamin D3 in Vitamin D deficient asthma patients did not reduce the rate of asthma treatment failure when compared with placebo. 

2. Vitamin D3 supplementation allowed for a small decrease in the dose of ciclesonide required for symptomatic control as compared with placebo. 

Evidence Rating Level: 1 (Excellent)

Study Rundown: Low vitamin D levels have been theorized to contribute to asthma severity through a variety of mechanisms, including immunomodulation. Low vitamin D levels may exacerbate airway inflammation and decrease response to steroid therapy, a mainstay of asthma treatment.

This study examined the effect of supplementing inhaled ciclesonide with vitamin D3 on asthma outcomes in patients with vitamin D levels < 30 ng/ml and symptomatic asthma. The primary measure of time to failure of asthma treatment – defined as decline in pulmonary function, increase in B-agonist or steroid use, and ED or hospitalization for systemic corticosteroids – showed no statistical difference between the D3 and placebo groups. Secondary measures were not statistically significant between the two groups, except that the D3 group received 14.9 µg/d less in cumulative ciclesonide dosing.

This study was limited by a low rate of asthma treatment failure in the control group as well as variable vitamin D serum levels after supplementation. Thus, future studies may demonstrate statistically significant differences in treatment failure with larger sample sizes and may potentially capture long-term benefits or risks of vitamin D3 supplementation that were missed by this short study period of 28 weeks. Nevertheless, this study demonstrates no role for vitamin D supplementation in asthma patients at this time.

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Click to read the study, published today in JAMA

Relevant Reading: Vitamin D and Asthma

In-Depth [randomized controlled trial]: This study was a randomized controlled trial in which participants were initiated on an inhaled ciclesonide and levabuterol regimen and were randomized to either a placebo supplementation group (n=207) or a high-dose Vitamin D3 supplementation group (n=201). Patients received 320 µg/d of ciclesonide for 12 weeks before being tapered to 160 µg/d for 8 weeks and 80 µg/d for 8 weeks. The rate of first treatment failure was not reduced in the Vitamin D3 group compared to placebo (28% vs. 29%, respectively, p=0.54) in the study period. The only statistically significant finding among the secondary outcome measures was the overall ciclesonide dose to achieve asthma control. The Vitamin D3 group received 111.3 µg/d whereas the placebo group received 126.2 µg/d – a small difference of 14.9 µg/d (p=.03).

©2012-2014 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT.

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