Higher 25-hydroxyvitamin D levels are associated with greater odds of remission with anti-tumour necrosis factor-[alpha] medications among patients with inflammatory bowel diseases

• Published in: Alimentary pharmacology & therapeutics 2017-03, Vol.45 (5), p.653
• Main Authors: Winter, R W, Collins, E, Cao, B, Carrellas, M, Crowell, A M, Korzenik, J R
• Format: Article
• Language: English
• Subjects: 25-Hydroxyvitamin D; Bowel disease; Gangrene; Inflammatory bowel diseases; Infliximab; Intestine; Monoclonal antibodies; Remission; Tempering; Tumor necrosis factor-TNF; Tumor necrosis factor-α; Tumors; Vitamin D
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/apt.13936

Summary Background Vitamin D has been linked to disease activity among patients with inflammatory bowel diseases (IBD). Prior investigation has also suggested that vitamin D levels may affect duration of therapy with anti-tumour necrosis factor-[alpha] (anti-TNF-[alpha]) medications among patients with IBD. Aim To evaluate the relationship between vitamin D levels and odds of reaching remission while on an anti-TNF-[alpha] medication. Methods A total of 521 IBD patients enrolled in the Brigham and Women's IBD Centre database were eligible for inclusion. Patients treated with anti-TNF-[alpha] therapy who had vitamin D levels drawn within 6 months prior or 2 weeks after initiation of anti-TNF-[alpha] medication and who had reported remission status at 3 months were included. A logistic regression model adjusting for age, gender, IBD diagnosis, anti-TNF-[alpha] medication (infliximab vs. adalimumab) and first or subsequent anti-TNF-[alpha] medication was used to identify the effect of vitamin D level on initial response to anti-TNF-[alpha] therapy. Results A total of 173 patients were included in the final analysis. On logistic regression, patients with normal vitamin D levels n = 122 at the time of anti-TNF-[alpha] medication initiation had a 2.64 increased odds of remission at 3 months compared to patients with low vitamin D levels n = 51 when controlling for age, gender, diagnosis, type of anti-TNF-[alpha] medication and first or subsequent anti-TNF-[alpha] medication (OR = 2.64, 95% CI = 1.31-5.32, P = 0.0067). Conclusions These findings suggest that vitamin D levels may influence initial response to anti-TNF-[alpha] medication and that low vitamin D levels may pre-dispose patients to decreased odds of remission.