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Meta-Analysis
. 2024 Dec;135(6):685-692.
doi: 10.1111/bcpt.14092. Epub 2024 Oct 13.

Efficacy of weekly versus daily cholecalciferol for repleting serum vitamin D (25(OH)D) deficiency: A systematic review and meta-analysis of randomized controlled trials

Émilie Bortolussi-Courval  1 , Connor Prosty  2 , Jimin J Lee  1 , Lisa M McCarthy  3   4 , Emily G McDonald  1   2   5 , Todd C Lee  1   2   6
Affiliations
Meta-Analysis

Efficacy of weekly versus daily cholecalciferol for repleting serum vitamin D (25(OH)D) deficiency: A systematic review and meta-analysis of randomized controlled trials

Émilie Bortolussi-Courval et al. Basic Clin Pharmacol Toxicol. 2024 Dec.

Abstract

Background/rationale: Weekly cholecalciferol can replace daily supplementation to reduce pill burden in patients with complex medication regimens and hypovitaminosis D, but evidence supporting this switch is unclear.

Objective: We aimed to determine whether weekly cholecalciferol was superior to daily cholecalciferol to replete patients with hypovitaminosis D.

Methods: We conducted a systematic review of randomized controlled trials involving participants with baseline hypovitaminosis D (<30 ng/ml) comparing weekly versus daily cholecalciferol dosing and where serum cholecalciferol was measured within 120 days of starting treatment. We searched MEDLINE, CINAHL and EMBASE from inception to 7 May 2024. A random-effects meta-analysis evaluated the odds ratio for repletion of serum vitamin D levels.

Findings: Eight trials involving 542 patients were included in the analysis. Weekly and daily cholecalciferol were not significantly different in correcting hypovitaminosis D (OR = 1.5, 95% CI = 0.3-6.9, p = 0.6, favouring weekly dosing, I2 = 85.3%). A sensitivity analysis excluding otherwise healthy patients had similar findings (OR = 0.8, 95% CI = 0.3-2.1, p = 0.6). Most studies were at risk of bias; the different doses being compared increased the heterogeneity.

Conclusions: Limited direct evidence supports a switch from daily to weekly cholecalciferol dosing; however, weekly supplementation was not demonstrably worse at repleting levels and decreased a patient's daily pill burden.

Keywords: cholecalciferol; deprescribing; dosing strategy; meta‐analysis; systematic review.

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Conflict of interest statement

None of the other authors have any relevant conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
FIGURE 2
FIGURE 2
Forest plot of the efficacy of daily versus weekly cholecalciferol to replete patients with hypovitaminosis D. Exponentiated OR = 1.5 [0.32–6.9], favouring weekly dosing.
See this image and copyright information in PMC

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