Article Abstract

Single high-dose oral vitamin D3 treatment in New Zealand children with inflammatory bowel disease

Authors: Natalie G. Martin, Tarah Rigterink, Mustafa Adamji, Catherine L. Wall, Andrew S. Day


Background: High-dose oral vitamin D (stoss) is a novel treatment in children with inflammatory bowel disease (IBD). Vitamin D supplementation may have benefits in IBD beyond bone health including reduced disease activity and improvements in inflammatory markers. The aim of this study was to retrospectively assess the efficacy, safety and impact on disease activity of single oral high-dose vitamin D3 therapy in New Zealand (NZ) children with IBD and vitamin D deficiency.
Methods: In this retrospective chart review, children with IBD and vitamin D deficiency [serum 25-OH vitamin D level (25-OHD) <50 nmol/L] in Christchurch, NZ, who were managed with single high-dose vitamin D3 therapy were identified. Measurements of serum 25-OHD, calcium and standard serum inflammatory markers prior to and up to 6 months following stoss therapy were extracted from patient records. Disease activity was also defined using the Pediatric Crohn’s Disease (CD)Activity Index (PCDAI) at time points before and 3-months following stoss.
Results: Twenty-eight doses of stoss were given to 23 children, aged 3–16 years. Mean 25-OHD levels increased after stoss therapy from 39 nmol/L (95% CI: 37–42 nmol/L) at baseline to 189 nmol/L (148–231 nmol/L) at 1–2 months (P<0.001). All children with 1-month levels measured achieved 25-OHD >75 nmol/L. One child had a serum calcium of 2.7 (normal range, 2.2 to 2.6 mmol/L) 2 weeks after treatment, which normalized on repeat testing ten days later. PCDAI scores, mean platelet count, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) all reduced significantly from baseline to 3 months following stoss therapy.
Conclusions: Single high-dose oral vitamin D therapy was used successfully and safely to manage vitamin D deficiency in these children with IBD. An improvement in inflammatory markers and disease activity scores also occurred following stoss therapy.