Vitamin D supplementation to prevent acute respiratory infections: individual participant data meta-analysis

• Published in: Health technology assessment (Winchester, England) England), 2019-01, Vol.23 (2), p.1-44
• Main Authors: Martineau, Adrian R, Jolliffe, David A, Greenberg, Lauren, Aloia, John F, Bergman, Peter, Dubnov-Raz, Gal, Esposito, Susanna, Ganmaa, Davaasambuu, Ginde, Adit A, Goodall, Emma C, Grant, Cameron C, Janssens, Wim, Jensen, Megan E, Kerley, Conor P, Laaksi, Ilkka, Manaseki-Holland, Semira, Mauger, David, Murdoch, David R, Neale, Rachel, Rees, Judy R, Simpson, Steve, Stelmach, Iwona, Trilok Kumar, Geeta, Urashima, Mitsuyoshi, Camargo, Carlos A, Griffiths, Christopher J, Hooper, Richard L
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Body Mass Index; Child; Child, Preschool; Cholecalciferol - administration & dosage; Comorbidity; Dietary Supplements; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Ergocalciferols - administration & dosage; Female; Humans; Infant; Influenza Vaccines - administration & dosage; Male; Medicin och hälsovetenskap; Middle Aged; Randomized Controlled Trials as Topic; Respiratory Tract Infections - prevention & control; Vitamin D - administration & dosage; Vitamin D - therapeutic use; Vitamin D Deficiency - drug therapy; Young Adult
• ISSN: 1366-5278; 2046-4924; 2046-4924
• DOI: 10.3310/hta23020

Randomised controlled trials (RCTs) exploring the potential of vitamin D to prevent acute respiratory infections have yielded mixed results. Individual participant data (IPD) meta-analysis has the potential to identify factors that may explain this heterogeneity. To assess the overall effect of vitamin D supplementation on the risk of acute respiratory infections (ARIs) and to identify factors modifying this effect. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, ClinicalTrials.gov and the International Standard Randomised Controlled Trials Number (ISRCTN) registry. Randomised, double-blind, placebo-controlled trials of supplementation with vitamin D or vitamin D of any duration having incidence of acute respiratory infection as a prespecified efficacy outcome were selected. Study quality was assessed using the Cochrane Collaboration Risk of Bias tool to assess sequence generation, allocation concealment, blinding of participants, personnel and outcome assessors, completeness of outcome data, evidence of selective outcome reporting and other potential threats to validity. We identified 25 eligible RCTs (a total of 11,321 participants, aged from 0 to 95 years). IPD were obtained for 10,933 out of 11,321 (96.6%) participants. Vitamin D supplementation reduced the risk of ARI among all participants [adjusted odds ratio (aOR) 0.88, 95% confidence interval (CI) 0.81 to 0.96; heterogeneity