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Vitamin D used as adjuvant therapy in children with severe atopic dermatitis may improve clinical outcomes, according to a recent study.
Vitamin D used as adjuvant therapy in children with severe atopic dermatitis (AD) may improve clinical outcomes, according to study Posted in Pharmacological research and perspectives.
Previously, vitamin D supplementation produced positive results in mild and moderate AD. Currently, conventional treatments for AD include immunomodulatory agents; however, control of AD remains difficult to achieve in some patients, which “suggests the presence of some other associated factors,” the authors explained, and it has been suggested that a vitamin D deficiency “may be a factor to consider. in the pathophysiology of AD. “
The researchers conducted a double-blind, randomized, parallel, placebo-controlled study at the National Hepatology and Tropical Medicine Research Institute in Cairo, Egypt. The study included patients with severe AD aged 5-16 years from 6 June 2018 to 1 September 2018. A total of 86 patients completed the study and were included in the final analysis.
Patients were randomized to receive vitamin D3 1600 IU / day or placebo. Both groups also received basal therapy with 1% hydrocortisone topical cream twice daily for 2 weeks. The group receiving vitamin D showed significant improvement in serum levels of 25 (OH) D, a measure of vitamin D deficiency, from baseline (P. ≤ 001). In the group receiving placebo, 25 (OH) D levels were comparable to baseline (P. = .47).
The mean change in Eczema Area and Severity Index (EASI) score from baseline was significantly greater among patients in the vitamin D group (56.44%) than among patients in the placebo group (42.09%; P. = 0.039). While 38.6% of patients receiving vitamin D achieved ≥ 75% improvement in the EASI score (EASI75), only 7.1% of patients in the placebo group achieved the same improvement.
However, the authors noted that the percentage of non-responders between the 2 groups was comparable (59.5% in the vitamin D group vs 52.2% in the placebo group). “This indicates that some integrated patients might get too much benefit from the treatment,” they explained.
They noted that there was a good correlation between BMI and percentage change in score for EASI75 respondents, but more studies are needed to better understand the relationship.
Some of the study’s highlighted limitations were the limited ethnic diversity among patients, potentially limiting the generalizability of the results, and the lack of data from other domains such as patient-reported outcomes. The authors also pointed out that seasonal fluctuations also characterize AD, with AD aggravated during the winter.
“We support further multicenter studies with a larger sample of a diverse ethnic population to validate the potential benefit of vitamin D on the clinical outcomes of severe pediatric eczema,” the authors concluded. “Further studies are also needed to examine whether the positive impact of supplementation would be maintained in pediatrics with severe winter-related eczema.”
Reference
Mansour NO, Mohamed AA, Hussein M, et al. The impact of vitamin D supplementation as adjuvant therapy on clinical outcomes in patients with severe atopic dermatitis: a randomized controlled trial. Pharmacol Res Perspect. Published online November 3, 2020. doi: 10.1002 / prp2.679
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