Efeito da suplementação de vitamina D nas exacerbações pulmonares da fibrose cística : um ensaio clínico randomizado crossover

Detalhes bibliográficos
Ano de defesa: 2021
Autor(a) principal: Ongaratto, Renata lattes
Orientador(a): Pinto, Leonardo Araújo lattes
Banca de defesa: Não Informado pela instituição
Tipo de documento: Tese
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul
Programa de Pós-Graduação: Programa de Pós-Graduação em Medicina/Pediatria e Saúde da Criança
Departamento: Escola de Medicina
País: Brasil
Palavras-chave em Português:
Palavras-chave em Inglês:
Área do conhecimento CNPq:
Link de acesso: http://tede2.pucrs.br/tede2/handle/tede/9934
Resumo: Background: Pulmonary exacerbations are associated with a worse evolution of cystic fibrosis (CF) and their control is of great importance in the treatment of disease. Extra skeletal properties of vitamin D have been pointed out, but the effect of its supplementation on markers of CF-related pulmonary disease is unclear. Methods: A randomized crossover trial conducted at a CF center in southern Brazil was used to evaluate the effect of an extra-dose supplementation regimen of vitamin D (5,000 IU/day <5 years and 10,000 IU/day ≥5 years) on pulmonary exacerbations in CF patients. Subjects were randomly allocated to receive vitamin D followed by standard treatment, or standard treatment followed by vitamin D for three months. Each treatment period was separated by a 9-month washout. The primary outcome was the number of pulmonary exacerbations during the intervention period. Additionally, a period of six months after the use of the extra dose of vitamin D was evaluated. The change in serum concentration of 25(OH)D after the end of supplementation was evaluated as a secondary outcome. Results: Thirty-four patients participated in the study (median age 5.16 years). Sixteen patients received vitamin D first, and 18 received standard treatment first. There was a borderline statistical difference (p=0.10) in pulmonary exacerbations during the use of the extra dose of vitamin D. No effect of vitamin D on pulmonary exacerbations was observed in a period of six months after the end of supplementation. More than half of the patients had suboptimal levels of 25(OH)D pre-supplementation, and only 58% achieved desirable vitamin levels. Conclusion: Our findings indicate a possible effect of vitamin D in reducing CF pulmonary exacerbations and reinforce the high prevalence of hypovitaminosis D in these patients, despite routine vitamin supplementation. Large studies, multicenter studies and/or metanalyses are necessary. Brazilian Clinical Trials Registry (ReBEC): RBR-439vzm