Effects of vitamin D supplementation on the outcomes of patients with pulmonary tuberculosis: a systematic review and meta-analysis

• Published in: BMC pulmonary medicine 2018-06, Vol.18 (1), p.108-108, Article 108
• Main Authors: Wu, Hong-Xia, Xiong, Xiao-Feng, Zhu, Min, Wei, Jia, Zhuo, Kai-Quan, Cheng, De-Yun
• Format: Article
• Language: English
• Subjects: Antitubercular Agents - therapeutic use; Care and treatment; Dietary Supplements; Health aspects; Humans; Immune response; Meta-analysis; Mortality; Mycobacterium tuberculosis - drug effects; Patient outcomes; Pulmonary tuberculosis; Pulmonology; Sputum - microbiology; Supplements; Systematic review; Therapy; Treatment Outcome; Tuberculosis; Tuberculosis, Pulmonary - drug therapy; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D - therapeutic use
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-018-0677-6

Vitamin D is involved in the host immune response toward Mycobacterium tuberculosis. However, the efficacy of vitamin D supplementation on sputum conversion, clinical response to treatment, adverse events, and mortality in patients with pulmonary tuberculosis (PTB) remains controversial. We aimed to clarify the efficacy and safety of vitamin D supplementation in PTB treatment. We searched Medline, Embase, Cochrane Central Register of Controlled Trials, Web of Science for double-blind, randomized controlled trials of vitamin D supplementation in patients with PTB that reported sputum conversion, clinical response to treatment, adverse events, or mortality, published from database inception to November 26, 2017. This study was registered with PROSPERO, number CRD42018081236. A total of 1787 patients with active PTB receiving vitamin D supplementation along with standard anti-tuberculosis regimen were included in the eight trials with different doses of vitamin D ranging from 1000 IU/day to 600,000 IU/month at different intervals. Primary analysis revealed that vitamin D supplementation increased the proportion of sputum smear and culture conversions (OR 1.21, 95%CI 1.05~ 1.39, z = 2.69, P = 0.007; OR 1.22, 95%CI 1.04~ 1.43, z = 2.41, P = 0.02), but did not improve the time to sputum smear and culture conversions (HR 1.07, 95%CI 0.83~ 1.37, z = 0.50, P = 0.62; HR 0.97, 95%CI 0.76~ 1.23, z = 0.29, P = 0.77). In the secondary analysis, vitamin D improved serum 25(OH)D, plasma calcium concentration, lymphocyte count, and chest radiograph (MD 103.36, 95%CI 84.20~ 122.53, z = 10.57, P