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. 2021 Feb 7;8(1):00662-2021.
doi: 10.1183/23120541.00662-2021. eCollection 2022 Jan.

Vitamin D supplementation in childhood asthma: a systematic review and meta-analysis of randomised controlled trials

Jogender Kumar  1   2 , Prawin Kumar  3   2 , Jagdish Prasad Goyal  3 , Chirag Thakur  3 , Puja Choudhary  3 , Jitendra Meena  1 , Jaykaran Charan  4 , Kuldeep Singh  3 , Atul Gupta  5
Affiliations

Vitamin D supplementation in childhood asthma: a systematic review and meta-analysis of randomised controlled trials

Jogender Kumar et al. ERJ Open Res. .

Abstract

Background: There is conflicting evidence for vitamin D supplementation in childhood asthma. We aimed to systematically synthesise the evidence on the efficacy and safety of vitamin D supplementation in childhood asthma.

Methods: We searched electronic databases (Medline, Embase and Web of Science) and a register (CENTRAL) for randomised controlled trials (RCTs) published until 30 September 2021. RCTs enrolling asthmatic children (1-18 years old) and comparing vitamin D against placebo/routine care were included if they met at least one of the endpoints of interest (asthma attacks, emergency visits or hospitalisation). We used the Risk of Bias 2 tool for risk of bias assessment. Random-effects meta-analysis with RevMan 5.3 software was performed. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the level of certainty of the evidence.

Results: 18 RCTs (1579 participants) were included. The pooled meta-analysis did not find a significant effect of vitamin D supplementation on asthma attacks requiring rescue systemic corticosteroids (six studies with 445 participants; risk ratio (RR) 1.13, 95% CI 0.86-1.48; I2=0%) (moderate-certainty evidence). In addition, there was no significant difference in the proportion of children with asthma attacks of any severity (11 trials with 1132 participants; RR 0.84, 95% CI 0.65-1.09; I2=58%) (very low-certainty evidence). Vitamin D does not reduce the need for emergency visits (three studies with 361 participants; RR 0.97, 95% CI 0.89-1.07; I2=0%) and hospitalisation (RR: 1.38, 95% CI 0.52-3.66; I2=0%) (low-certainty evidence).

Conclusion: Very low- to moderate-certainty evidence suggests that vitamin D supplementation might not have any protective effect in childhood asthma.

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Conflict of interest statement

Conflict of interest: J. Kumar has nothing to disclose. Conflict of interest: P. Kumar has nothing to disclose. Conflict of interest: J.P. Goyal has nothing to disclose. Conflict of interest: C. Thakur has nothing to disclose. Conflict of interest: P. Choudhary has nothing to disclose. Conflict of interest: J. Meena has nothing to disclose. Conflict of interest: J. Charan has nothing to disclose. Conflict of interest: K. Singh has nothing to disclose. Conflict of interest: A. Gupta has nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow chart.
FIGURE 2
FIGURE 2
Forest plot showing the proportion of children with asthma exacerbations requiring rescue systemic steroids. M-H: Mantel-Haenszel; df: degrees of freedom.
See this image and copyright information in PMC

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