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Is vitamin D effective and safe when used to reduce the risk of severe asthma exacerbations or to improve asthma control?
This systematic review does not find evidence to support a role for vitamin D supplementation in reducing the risk of asthma exacerbations or improving asthma control. The null findings of this review are based on the largest pool of evidence analysed to date, and are consistent for primary and secondary outcomes.
Nonetheless, participants with severe asthma and those with baseline 25-hydroxyvitamin D concentrations <25nmol/L were poorly represented, and a protective effect of the intervention cannot be excluded in these patient groups.
This review followed rigorous prespecified selection criteria, restricted to double-blind, placebo-controlled trials. It incorporated evidence across a wide range of patient populations in terms of age, country, baseline vitamin D status, and vitamin D dosing regimens. The evidence produced by this review was graded as high for the primary outcome and high to moderate for the majority of secondary outcomes.
Low blood levels of vitamin D have been linked to an increased risk of severe asthma attacks, defined as those requiring oral (systemic) steroid medications. Vitamin D metabolites can produce antimicrobial and anti-inflammatory activity. This might decrease the risk of asthma exacerbations, which are often precipitated by respiratory infection.
Williamson A, et al. Vitamin D for the management of asthma. Cochrane Database Syst Rev 2023;2:CD011511. This review contains 20 trials with a total of 2225 participants.
Prostate cancer consultations are common in primary care and there is no one approach to testing and treatment that fits all patients. Urologist Simon van Rij discusses the key considerations and options for personalised care, appropriate investigation and treatment
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