Adjunctive Vitamin D For Treatment Of Active Juvenile Idiopathic Arthritis:An Open-label,prospective,randomized Controlled Trial

Objective: Vitamin D has an important immunomodulatory effect,but no trial has examined the effect of boosting serum levels of25-hydroxyvitamin D(25OHD)in individuals with juvenile idiopathic arthritis(JIA).The aim here was to assess whether vitamin D supplementation reduced disease activity and adjusted/maintained bone mass in patients with active JIA.Methods: This 24-week randomized trial was undertaken at Children’s Hospital of Chongqing Medical University.Treatment-naive patients with JIA were randomly assigned(1:1)to one of two groups:standard treatment with high dose oral cholecalciferol [2000 IU per day;experimental group(EG)] or without supplementation [control group(CG)].The primary outcomes were the 27-joint Juvenile Arthritis Disease Activity Score(JADAS-27 score),the Z-score for bone mineral density(BMD),and serum levels of 25 OHD.A per-protocol analysis set approach was used.The Mann-Whitney U test was the main tool for data analysis.Results: 42 participants were assigned randomly to the EG(n=20)or the CG(n=22);of these,36(n=18 and n=18,respectively)were included in per-protocol analysis.After 24 weeks,the mean level of 25 OHD in the EG was higher than that in the CG(p<0.05).At the end of the intervention,there were no clear differences between the two groups in terms of BMD or JADAS-27 score(p>0.05 for both).Conclusions: Cholecalciferol supplementation(2000 IU/day)for 24 weeks raises serum levels of 25 OHD in JIA patients but does not reduce disease activity or improve BMD.