Vitamin D Supplementation for Childhood Asthma: A Systematic Review and Meta-Analysis.

There is growing evidence that vitamin D plays a role in the pathogenesis of asthma but it is unclear whether supplementation during childhood may improve asthma outcomes.The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of vitamin D supplementation as...

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Main Authors: Bruno D Riverin, Jonathon L Maguire, Patricia Li
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4556456?pdf=render
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spelling doaj-2c2e84e96c634b2495ef99f1b06f6e232020-11-25T01:14:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01108e013684110.1371/journal.pone.0136841Vitamin D Supplementation for Childhood Asthma: A Systematic Review and Meta-Analysis.Bruno D RiverinJonathon L MaguirePatricia LiThere is growing evidence that vitamin D plays a role in the pathogenesis of asthma but it is unclear whether supplementation during childhood may improve asthma outcomes.The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of vitamin D supplementation as a treatment or adjunct treatment for asthma.We searched MEDLINE, Embase, CENTRAL, and CINAHL through July 2014.We included RCTs that evaluated vitamin D supplementation in children versus active control or placebo for asthma.One reviewer extracted data and one reviewer verified data accuracy. We qualitatively summarized the main results of efficacy and safety and meta-analyzed data on comparable outcomes across studies. We used GRADE for strength of evidence.Main planned outcomes measures were ED visits and hospitalizations. As secondary outcomes, we examined measures of asthma control, including frequency of asthma exacerbations, asthma symptom scores, measures of lung function, β2-agonist use and daily steroid use, adverse events and 25-hydroxyvitamin D levels.Eight RCTs (one parallel, one crossover design) comprising 573 children aged 3 to 18 years were included. One study (moderate-quality, n = 100) reported significantly less ED visits for children treated with vitamin D. No other studies examined the primary outcome (ED visits and hospitalizations). There was a reduced risk of asthma exacerbations in children receiving vitamin D (low-quality; RR 0.41, 95% CI 0.27 to 0.63, 3 studies, n = 378). There was no significant effect for asthma symptom scores and lung function. The serum 25(OH)D level was higher in the vitamin D group at the end of the intervention (low-quality; MD 19.66 nmol/L, 95% CI 5.96 nmol/L to 33.37 nmol/L, 5 studies, n = 167).We identified a high degree of clinical diversity (interventions and outcomes) and methodological heterogeneity (sample size and risk of bias) in included trials.Randomized controlled trials provide some low-quality evidence to support vitamin D supplementation for the reduction of asthma exacerbations. Evidence on the benefits of vitamin D supplementation for other asthma-related outcomes in children is either limited or inconclusive. We recommend that future trials focus on patient-relevant outcomes that are comparable across studies, including standardized definitions of asthma exacerbations.http://europepmc.org/articles/PMC4556456?pdf=render
collection DOAJ
language English
format Article
sources DOAJ
author Bruno D Riverin
Jonathon L Maguire
Patricia Li
spellingShingle Bruno D Riverin
Jonathon L Maguire
Patricia Li
Vitamin D Supplementation for Childhood Asthma: A Systematic Review and Meta-Analysis.
PLoS ONE
author_facet Bruno D Riverin
Jonathon L Maguire
Patricia Li
author_sort Bruno D Riverin
title Vitamin D Supplementation for Childhood Asthma: A Systematic Review and Meta-Analysis.
title_short Vitamin D Supplementation for Childhood Asthma: A Systematic Review and Meta-Analysis.
title_full Vitamin D Supplementation for Childhood Asthma: A Systematic Review and Meta-Analysis.
title_fullStr Vitamin D Supplementation for Childhood Asthma: A Systematic Review and Meta-Analysis.
title_full_unstemmed Vitamin D Supplementation for Childhood Asthma: A Systematic Review and Meta-Analysis.
title_sort vitamin d supplementation for childhood asthma: a systematic review and meta-analysis.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2015-01-01
description There is growing evidence that vitamin D plays a role in the pathogenesis of asthma but it is unclear whether supplementation during childhood may improve asthma outcomes.The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of vitamin D supplementation as a treatment or adjunct treatment for asthma.We searched MEDLINE, Embase, CENTRAL, and CINAHL through July 2014.We included RCTs that evaluated vitamin D supplementation in children versus active control or placebo for asthma.One reviewer extracted data and one reviewer verified data accuracy. We qualitatively summarized the main results of efficacy and safety and meta-analyzed data on comparable outcomes across studies. We used GRADE for strength of evidence.Main planned outcomes measures were ED visits and hospitalizations. As secondary outcomes, we examined measures of asthma control, including frequency of asthma exacerbations, asthma symptom scores, measures of lung function, β2-agonist use and daily steroid use, adverse events and 25-hydroxyvitamin D levels.Eight RCTs (one parallel, one crossover design) comprising 573 children aged 3 to 18 years were included. One study (moderate-quality, n = 100) reported significantly less ED visits for children treated with vitamin D. No other studies examined the primary outcome (ED visits and hospitalizations). There was a reduced risk of asthma exacerbations in children receiving vitamin D (low-quality; RR 0.41, 95% CI 0.27 to 0.63, 3 studies, n = 378). There was no significant effect for asthma symptom scores and lung function. The serum 25(OH)D level was higher in the vitamin D group at the end of the intervention (low-quality; MD 19.66 nmol/L, 95% CI 5.96 nmol/L to 33.37 nmol/L, 5 studies, n = 167).We identified a high degree of clinical diversity (interventions and outcomes) and methodological heterogeneity (sample size and risk of bias) in included trials.Randomized controlled trials provide some low-quality evidence to support vitamin D supplementation for the reduction of asthma exacerbations. Evidence on the benefits of vitamin D supplementation for other asthma-related outcomes in children is either limited or inconclusive. We recommend that future trials focus on patient-relevant outcomes that are comparable across studies, including standardized definitions of asthma exacerbations.
url http://europepmc.org/articles/PMC4556456?pdf=render
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