image: Chief of pediatric pulmonary medicine at UPMC Children's Hospital of Pittsburgh, and the Niels K. Jerne chair of Pediatrics at the University of Pittsburgh School of Medicine view more
Credit: UPMC
PITTSBURGH, Aug. 25, 2020 - Contrary to earlier results, vitamin D supplements do not prevent severe asthma attacks in at-risk children, according to the first placebo-controlled clinical trial to test this relationship.
These results were published today in JAMA.
"The reason that's important is there are colleagues around this country and worldwide who are testing vitamin D levels for kids with asthma and giving them vitamin D," said study lead author Juan C. Celedón, M.D., Dr.P.H., chief of pediatric pulmonary medicine at UPMC Children's Hospital of Pittsburgh. "As a system, it costs a lot of money to run all these tests and give the supplements. We've shown no benefit for children with moderately low vitamin D levels."
For three years, the Vitamin-D-Kids Asthma (VDKA) Study followed nearly 200 children ages 6 to 16 across seven different U.S. hospital systems. All had at least one asthma attack during the year before the study began.
Half of the participants were randomized to receive 4,000 IU of vitamin D per day, and the other half got placebo pills. No one involved in the study knew which type of pill each participant was getting.
All of the children had vitamin D levels low enough that supplements should have an effect -- if vitamin D truly is beneficial for reducing severe asthma attacks -- but the study excluded children with severe vitamin D deficiency because it would be unethical to withhold it in those cases.
Compared to placebo, vitamin D did not reduce the number of asthma attacks participants experienced or their reliance on inhaled steroids.
That's different from what was seen in the past with observational studies in Costa Rica, the U.S. and Canada, and Puerto Rico, where children with naturally low vitamin D levels seemed to have worse asthma.
"With observational studies, you never know -- is vitamin D causing asthma to be worse or do kids with worse asthma end up having lower vitamin D?" said Celedón, who also holds the Niels K. Jerne chair of Pediatrics at the University of Pittsburgh School of Medicine.
Even with the rigor of the present study's design, Celedón acknowledges that he can't draw conclusions about whether very low vitamin D levels contribute to asthma attacks, but he argues that those children would be supplemented either way because of known effects on bone health.
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Additional authors on the study include first author Erick Forno, M.D., M.P.H., and coauthors Franziska Rosser, M.D., M.P.H., and Yueh-Ying Han, Ph.D., of UPMC Children's Hospital and Pitt; Leonard Bacharier, M.D., and Joshua Blatter, M.D., M.P.H., of Saint Louis Children's Hospital; Wanda Phipatanakul, M.D., M.S., of Boston Children's Hospital; Theresa Guilbert, M.D., M.S., and Sandy Durrani, M.D., of Cincinnati Children's Hospital; Michael Cabana, M.D., M.P.H., of UCSF Benioff Children's Hospital; Kristie Ross, M.D., M.S., of UH Rainbow Babies and Children's Hospital; Ronina Covar, M.D., of University of Colorado Denver; James Gern, M.D., of University of Wisconsin-Madison School of Medicine and Public Health; and Stephen Wisniewski, Ph.D., of Pitt.
This trial was funded by the National Heart, Lung, and Blood Institute (grant HL119952). The vitamin D and placebo capsules given to participants were supplied by Pharmavite, and GlaxoSmithKline provided steroid inhalers. Neither company had a role in the design, implementation or data analysis for the study. Celedón has received a steroid inhaler from Merck for another, unrelated study. Conflicts of interest for other authors are disclosed in the study.
To read this release online or share it, visit https://www.upmc.com/media/news/082520-Celedon-JAMA-Vit-D [when embargo lifts].
About UPMC Children's Hospital of Pittsburgh
Regionally, nationally, and globally, UPMC Children's Hospital of Pittsburgh is a leader in the treatment of childhood conditions and diseases, a pioneer in the development of new and improved therapies, and a top educator of the next generation of pediatricians and pediatric subspecialists. With generous community support, UPMC Children's Hospital has fulfilled this mission since its founding in 1890. UPMC Children's is recognized consistently for its clinical, research, educational, and advocacy-related accomplishments, including ranking in the top 10 on the 2019-2020 U.S. News & World Report Honor Roll of America's Best Children's Hospitals. UPMC Children's also ranks 15th among children's hospitals and schools of medicine in funding for pediatric research provided by the National Institutes of Health (FY2018).About the University of Pittsburgh School of Medicine
As one of the nation's leading academic centers for biomedical research, the University of Pittsburgh School of Medicine integrates advanced technology with basic science across a broad range of disciplines in a continuous quest to harness the power of new knowledge and improve the human condition. Driven mainly by the School of Medicine and its affiliates, Pitt has ranked among the top 10 recipients of funding from the National Institutes of Health since 1998. In rankings recently released by the National Science Foundation, Pitt ranked fifth among all American universities in total federal science and engineering research and development support.
Likewise, the School of Medicine is equally committed to advancing the quality and strength of its medical and graduate education programs, for which it is recognized as an innovative leader, and to training highly skilled, compassionate clinicians and creative scientists well-equipped to engage in world-class research. The School of Medicine is the academic partner of UPMC, which has collaborated with the University to raise the standard of medical excellence in Pittsburgh and to position health care as a driving force behind the region's economy. For more information about the School of Medicine, see http://www.medschool.pitt.edu.
Journal
JAMA