Vitamin D and Disease Severity in Multiple Sclerosis—Baseline Data From the Randomized Controlled Trial (EVIDIMS)
Priscilla Bäcker‐Koduah, Judith Bellmann–Strobl, Michael Scheel, Jens Wuerfel, Klaus‐Dieter Wernecke, Jan Dörr, Alexander U. Brandt, Friedemann Paul
Abstract
Objective: To investigate the associations between hypovitaminosis D and disease activity in a cohort of relapsing remitting multiple sclerosis (RRMS) and clinically isolated syndrome (CIS) patients. Methods: In 51 RRMS and 2 CIS patients on stable interferon-β-1b (IFN-β-1b) treatment recruited to the EVIDIMS study (Efficacy of Vitamin D Supplementation in Multiple Sclerosis (NCT01440062) baseline serum vitamin D levels were evaluated. Patients were dichotomized based on the definition of vitamin D deficiency reflected by a 25-hydroxyvitamin D (25(OH)D) level <30 ng/ml vs ≥ 30 ng/ml. Possible associations between vitamin D deficiency and both clinical and MRI features of the disease were analyzed. Results: Median (25%, 75% quartiles, Q) 25(OH)D level was 18 ng/ml (12, 24). 48 out of 53 (91%) patients had 25(OH)D levels < 30 ng/ml (p < 0.001). Patients with 25(OH)D ≥ 30 ng/ml had lower median (25%, 75% Q) T2-weighted lesion counts (25 (24, 33)) compared to patients with 25(OH)D < 30 ng/ml (60 (36, 84), p = 0.03; adjusted for age, gender and disease duration: p < 0.001). EDSS score were negatively associated with serum 25(OH)D levels in multiple linear regression, including age, sex and disease duration (adjusted: p < 0.001). Interpretation: Most patients recruited in the EVIDIMS study were vitamin D deficient. Higher 25(OH)D levels were associated with reduced T2 weighted lesion count and lower EDSS scores.