Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb;8(2):517-522.
doi: 10.4103/jfmpc.jfmpc_446_18.

Effect of 1,25 dihydroxy vitamin D3 supplementation on pain relief in early rheumatoid arthritis

Dibyendu Mukherjee  1 , Sandeep Lahiry  2 , Sayanta Thakur  3 , Dwaipayan Sarathi Chakraborty  3
Affiliations

Effect of 1,25 dihydroxy vitamin D3 supplementation on pain relief in early rheumatoid arthritis

Dibyendu Mukherjee et al. J Family Med Prim Care. 2019 Feb.

Abstract

Background: To assess effect of 1,25 dihydroxy vitamin D3 supplementation on pain relief in early rheumatoid arthritis (RA).

Materials and methods: An open-labeled randomized trial was conducted comparing 60,000 IU 1,25 dihydroxy vitamin D3 + calcium (1000 mg/day) combination [Group A] versus calcium (1000 mg/day) only [Group B], as supplement to existing treatment regimen in early RA. Primary outcome included (i) minimum time required for onset of pain relief (Tm) assessed through patients' visual analog scale (VAS); (ii) % change in VAS score from onset of pain relief to end of 8 weeks. Secondary outcome included change in disease activity score (DAS-28).

Results: At the end of 8-weeks, Group A reported 50% higher median pain relief scores (80% vs. 30%; P < 0.001) and DAS-28 scores (2.9 ± 0.6 vs. 3.1 ± 0.4; P = 0.012) compared to Group B; however, Tm remained comparable (19 ± 2 vs. 20 ± 2 days; P = 0.419). Occurrence of hypovitaminosis-D was lower (23.3%) compared to Indian prevalence rates and was a risk factor for developing active disease (Odds Ratio (OR) = 7.52 [95% Confidence Interval (CI) 2.67-21.16], P < 0.0001). Vitamin D deficiency was significantly (P < 0.001) more common in female gender, active disease, and shorter mean disease duration. Vitamin D levels were inversely correlated to disease activity as assessed by DAS-28 (r = -0.604; P < 0.001).

Conclusions: Vitamin-D deficiency is a risk factor for developing active disease in RA. Weekly supplementation of 60,000 IU of 1,25 dihydroxy vitamin D3 in early RA results in greater pain relief. The number needed to treat for this additional pain relief was 2.

Identifier: CTRI/2018/01/011532 (www.ctri.nic.in).

Keywords: 1,25 dihydroxy vitamin D3; early rheumatoid arthritis; pain relief; visual analogue scale.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Adapted CONSORT flow-diagram showing study outline
See this image and copyright information in PMC

References

    1. McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med. 2011;365:2205–19. - PubMed
    1. Khurana R, Berney SM. Clinical aspects of rheumatoid arthritis. Pathophysiology. 2005;12:153–65. - PubMed
    1. Keystone EC, Smolen J, van Riel P. Developing an effective treatment algorithm for rheumatoid arthritis. Rheumatology (Oxford) 2012;51:v48–54. - PubMed
    1. Sharma P, Pathak K. Are biological targets the final goal for rheumatoid arthritis therapy? Expert Opin Biol Ther. 2012;12:1611–22. - PubMed
    1. Hirani V. Vitamin D status and pain: Analysis from the Health Survey for England among English adults aged 65 years and over. Br J Nutr. 2012;107:1080–4. - PubMed