September 19, 2019

A small clinical trial published in Lupus Science & Medicine found that taking vitamin D supplements did not improve bone health for people with lupus.

Conducted by several lupus experts throughout the U.S., the study looked at the effect of vitamin D supplements on changes in bone turnover markers that indicate changes in bone loss and formation.

As study authors note: “Poor bone health is common in SLE due to disease and treatment. Patients with SLE have twice the fracture risk of individuals without SLE, and patients with SLE with nephritis are at even greater risk.”

They point out that many factors harm bone health including inflammation caused by lupus and lupus nephritis, use of steroids, premature menopause and vitamin D deficiency. Past studies have shown that higher vitamin D levels and lower lupus disease activity are associated with higher levels of bone formation markers. But there has not been data looking at whether restoring the proper levels of vitamin D can decrease bone turnover.

This clinical trial compared blood samples from 28 people with lupus given vitamin D supplementation at either 2000 or 4000 IU per day with 15 people with lupus who received placebo after 12 weeks. The levels of vitamin D increased significantly among those who received supplements. However, the changes in bone turnover markers did not differ between those receiving supplementation and those who did not.

Researchers concluded: “We advise that patients with SLE and their clinicians continue to follow the American College of Rheumatology’s Glucocorticoid-Induced Osteoporosis guidelines, which include optimising vitamin D intake, as the current study was not designed to investigate bone density or fracture outcomes. A larger, longer-term trial of vitamin D versus placebo in patients with SLE—particularly premenopausal women with high disease activity—using bone mineral density or bone microarchitecture as outcomes would help guide clinical care.”

The study was supported by the Lupus Foundation of America Career Development Award, the National Institutes of Health Autoimmunity Centers of Excellence and the National Institute of Arthritis, Musculoskeletal and Skin Diseases.