Vitamin D3 in Systemic Lupus Erythematosus

NCT ID: NCT00710021

Last Updated: 2017-04-26

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

57 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-11-30

Study Completion Date

2011-07-31

Brief Summary

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The purpose of this study is to explore the impact of vitamin D3 on the expression of alpha interferon (IFN alpha) expression in systemic lupus erythematosus (SLE) patients with vitamin D deficiency.

Detailed Description

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Systemic Lupus Erythematosus (SLE) is an autoimmune disease characterized by the production of autoantibodies with subsequent immune complex deposition and tissue inflammation. The role of interferon (IFN) alpha in the development of SLE has been repeatedly documented. Vitamin D deficiency is common among lupus patients. Vitamin D is recognized as a regulator of immune response. This study will explore the impact of vitamin D3 supplementation on IFN alpha expression in SLE patients.

The study will last approximately 12 weeks and consist of three treatment groups: 1.) Participants will receive vitamin D3 2000 IU daily 2.) Participants will receive vitamin D3 4000 IU daily 3.) Participants will receive a vitamin D3 placebo daily. There will be four study visits for each participant. Visits will occur at screening, study entry, and Weeks 6 and 12. Physical examination, vital signs, and blood and urine tests will occur at all visits. For females of childbearing potential, a pregnancy test will be performed at screening and Week 6.

Conditions

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Systemic Lupus Erythematosus SLE Lupus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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vitamin D3 2000 IU

Participants in this arm take a vitamin D3 dose of 2000 international units (IU) daily by mouth for a duration of 12 weeks.

Group Type EXPERIMENTAL

Vitamin D3

Intervention Type DRUG

8% vitamin D3 powder, 84% microcrystalline cellulose, 8% fumed silica by weight

vitamin D3 4000 IU

Participants in this arm take a vitamin D3 dose of 4000 international units (IU) daily by mouth for a duration of 12 weeks.

Group Type EXPERIMENTAL

Vitamin D3

Intervention Type DRUG

8% vitamin D3 powder, 84% microcrystalline cellulose, 8% fumed silica by weight

vitamin D3 placebo

Participants in this arm take a vitamin D3 placebo daily by mouth for a duration of 12 weeks.

Group Type PLACEBO_COMPARATOR

Vitamin D3 placebo

Intervention Type DRUG

86% microcrystalline cellulose, 14% fumed silica by weight

Interventions

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Vitamin D3

8% vitamin D3 powder, 84% microcrystalline cellulose, 8% fumed silica by weight

Intervention Type DRUG

Vitamin D3 placebo

86% microcrystalline cellulose, 14% fumed silica by weight

Intervention Type DRUG

Other Intervention Names

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Cholecalciferol Cholecalciferol placebo

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of SLE by American College of Rheumatology (ACR) criteria
* Serum 25-OH vitamin D level of 20 ng/mL or less
* Stable disease at screening, defined as a modified Safety of Estrogens in Lupus Erythematosus National Assessment SLE Disease Activity Index (SELENA-SLEDAI) of 4 or less
* Interferon (IFN) signature present. More information about this criterion can be found in the protocol
* Positive anti-double-stranded (anti-ds) DNA antibody blood test at screening
* If on corticosteroids, the dose must be less than 20 mg per day and stable for 4 weeks prior to screening and at study entry
* If on immunosuppressive or immunomodulatory medication such as azathioprine, methotrexate, leflunomide, mycophenolate, or hydroxychloroquine, the dose must be stable for 3 months prior to screening and at study entry
* If receiving a multivitamin or a vitamin D supplement, the dose of vitamin D must be 800 IU daily or less and stable for the 3 months prior to screening and at study entry
* Agree to use effective contraceptive methods for the duration of the study

Exclusion Criteria

* Unwilling to stop using drugs or substances that may interfere with fat absorption
* Hypercalcemia
* Hypercalciuria
* History of hyperparathyroidism
* History of kidney stones
* History of cancer, except cervical carcinoma in situ and resected basal and squamous cell carcinomas of the skin
* Known history of chronic viral infections, including human immunodeficiency virus (HIV), Hepatitis B, and Hepatitis C
* Known active tuberculosis
* Any British Isles Lupus Assessment Group (BILAG) A or B manifestation with the exception of a BILAG B mucocutaneous manifestation
* Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) liver function tests greater than or equal to two times the upper limit of normal
* Dialysis or serum creatinine greater than 1.5 mg/dL
* Expectation by the investigator to increase corticosteroid or immunosuppressive or immunomodulatory medication dose at screening, study entry, or over the course of the study
* Treatment with cyclophosphamide within 3 months of screening
* Treatment with rituximab within 12 months of screening
* Other investigational drug and or treatment during the 4 weeks or seven half lives of the other investigational drug prior to study entry
* Drug or alcohol abuse within 6 months prior to study entry
* Treatment with digoxin
* Treatment with teriparatide
* Any condition that, in the opinion of the investigator, would jeopardize the subject's safety following exposure to the study drug
* Pregnant or breastfeeding
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Autoimmunity Centers of Excellence

OTHER

Sponsor Role collaborator

National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Cynthia Aranow, MD

Role: STUDY_CHAIR

Northwell Health

Diane Kamen, MD

Role: STUDY_CHAIR

Medical University of South Carolina

Locations

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University of Alabama

Birmingham, Alabama, United States

Site Status

University of California, San Francisco

San Francisco, California, United States

Site Status

Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Feinstein Institute for Medical Research

Manhassett, New York, United States

Site Status

University of Rochester

Rochester, New York, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

University of Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

Countries

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United States

References

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Kamen DL, Cooper GS, Bouali H, Shaftman SR, Hollis BW, Gilkeson GS. Vitamin D deficiency in systemic lupus erythematosus. Autoimmun Rev. 2006 Feb;5(2):114-7. doi: 10.1016/j.autrev.2005.05.009. Epub 2005 Jun 21.

Reference Type BACKGROUND
PMID: 16431339 (View on PubMed)

Mangini AJ, Lafyatis R, Van Seventer JM. Type I interferons inhibition of inflammatory T helper cell responses in systemic lupus erythematosus. Ann N Y Acad Sci. 2007 Jun;1108:11-23. doi: 10.1196/annals.1422.002.

Reference Type BACKGROUND
PMID: 17893966 (View on PubMed)

Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, Schaller JG, Talal N, Winchester RJ. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271-7. doi: 10.1002/art.1780251101.

Reference Type BACKGROUND
PMID: 7138600 (View on PubMed)

Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997 Sep;40(9):1725. doi: 10.1002/art.1780400928. No abstract available.

Reference Type BACKGROUND
PMID: 9324032 (View on PubMed)

Isenberg DA, Rahman A, Allen E, Farewell V, Akil M, Bruce IN, D'Cruz D, Griffiths B, Khamashta M, Maddison P, McHugh N, Snaith M, Teh LS, Yee CS, Zoma A, Gordon C. BILAG 2004. Development and initial validation of an updated version of the British Isles Lupus Assessment Group's disease activity index for patients with systemic lupus erythematosus. Rheumatology (Oxford). 2005 Jul;44(7):902-6. doi: 10.1093/rheumatology/keh624. Epub 2005 Apr 6.

Reference Type BACKGROUND
PMID: 15814577 (View on PubMed)

Aranow C, Kamen DL, Dall'Era M, Massarotti EM, Mackay MC, Koumpouras F, Coca A, Chatham WW, Clowse ME, Criscione-Schreiber LG, Callahan S, Goldmuntz EA, Keyes-Elstein L, Oswald M, Gregersen PK, Diamond B. Randomized, Double-Blind, Placebo-Controlled Trial of the Effect of Vitamin D3 on the Interferon Signature in Patients With Systemic Lupus Erythematosus. Arthritis Rheumatol. 2015 Jul;67(7):1848-57. doi: 10.1002/art.39108.

Reference Type RESULT
PMID: 25777546 (View on PubMed)

Related Links

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https://www.niaid.nih.gov/

National Institute of Allergy and Infectious Diseases (NIAID) website

https://www.niams.nih.gov/Health_Info/Lupus/default.asp

National Institute of Arthritis and Musculoskeletal and Skin Diseases: Handout on Health-System Lupus Erythematosus

Other Identifiers

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DAIT ALE02

Identifier Type: -

Identifier Source: org_study_id

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