Vitamin D Repletion and Maintenance in IBD: How Much and How Often

NCT ID: NCT03053414

Last Updated: 2018-03-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2017-02-20

Study Completion Date

2018-12-01

Brief Summary

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Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn's disease (CD), are chronic relapsing inflammatory conditions of the gastrointestinal tract. IBD is thought to result from a complex interaction between genetic, immune, microbial and environmental factors. There is emerging data suggesting Vitamin D may not only play a role in bone health but may also be involved in gut health as well. While there are guidelines regarding the recommending doses of Vitamin D for supplementation and maintenance in bone health, these strategies are unknown in those with inflammatory bowel disease. The investigators seek to determine a dosing strategy for this population using doses within the recommended guidelines for bone health.

Detailed Description

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Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn's disease (CD), are chronic relapsing inflammatory conditions of the gastrointestinal tract. IBD is thought to result from a complex interaction between genetic, immune, microbial and environmental factors. The role of vitamin D in bone health and calcium homeostasis is well documented. However, emerging data suggests that vitamin D may also regulate immune responses, which may play a role in the pathogenesis and disease activity of IBD.

The investigators seek to identify CD or UC patients with mild disease or in clinical remission who have vitamin D levels \<30 ng/ml and not on any type of vitamin repletion therapy. The investigators will randomize the participants into one of four arms: (1) Oral 50,000 vitamin D IU every week for 12 weeks (2) Oral 50,000 vitamin D weekly for 12 weeks than oral 800 vitamin D IU/d (3) Oral 50,000 vitamin D IU weekly for 12 weeks then 5,000 vitamin D IU/d (4) Oral 5,000 vitamin D IU/d and check vitamin D levels and inflammatory markers as part of standard of care follow- up every 3 months for nine months. Every participant will receive dietary counseling throughout the study duration. Our aim is to identify an optimal dosing strategy for repletion and maintenance of vitamin D levels in the subset of IBD patients. Based on clinical experience, doses higher than the recommended doses for bone health are needed to achieve and maintain optimal levels of Vitamin D in IBD patients, even patients are in remission or do not have small bowel (malabsorption) involvement.

Conditions

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Inflammatory Bowel Diseases Vitamin D Deficiency

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomized to one of four treatment arms for the duration of the study. Labs will be checked every 3 months as part of standard of care to help delineate the best strategy for repletion and maintenance of Vitamin D levels throughout the study.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Treatment Arm # 1

50,000 IU oral vitamin D2 per week for 12 weeks + Dietary counseling

Group Type ACTIVE_COMPARATOR

Vitamin D (ergocalciferol and/ or cholecalciferol)

Intervention Type DIETARY_SUPPLEMENT

To evaluate effective repletion and supplementation for Vitamin D levels in patients with inflammatory bowel disease.

Treatment Arm # 2

50,000 IU oral vitamin D2 per week x 12 weeks then 800 IU/day oral vitamin D3 for 6 months + Dietary counseling

Group Type ACTIVE_COMPARATOR

Vitamin D (ergocalciferol and/ or cholecalciferol)

Intervention Type DIETARY_SUPPLEMENT

To evaluate effective repletion and supplementation for Vitamin D levels in patients with inflammatory bowel disease.

Treatment Arm # 3

50,000 IU oral vitamin D2 per week x 12 weeks then 5,000 IU/day oral vitamin D3 for 6 months+ Dietary counseling

Group Type ACTIVE_COMPARATOR

Vitamin D (ergocalciferol and/ or cholecalciferol)

Intervention Type DIETARY_SUPPLEMENT

To evaluate effective repletion and supplementation for Vitamin D levels in patients with inflammatory bowel disease.

Treatment Arm # 4

5,000 IU oral daily vitamin D3 for 9 months + Dietary counseling

Group Type ACTIVE_COMPARATOR

Vitamin D (ergocalciferol and/ or cholecalciferol)

Intervention Type DIETARY_SUPPLEMENT

To evaluate effective repletion and supplementation for Vitamin D levels in patients with inflammatory bowel disease.

Interventions

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Vitamin D (ergocalciferol and/ or cholecalciferol)

To evaluate effective repletion and supplementation for Vitamin D levels in patients with inflammatory bowel disease.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

1. Diagnosis of Crohn's disease or Ulcerative colitis
2. In clinical remission or with mild disease activity as determined by the Harvey Bradshaw Index (CD) ≤7 or Ulcerative Colitis disease activity index ≤6.
3. 25(OH)D level \<30 ng/ml within three months of study enrollment
4. Provided verbal consent
5. 18 years of age or older

Exclusion Criteria

1. Unwilling to provide consent or lack capacity
2. Moderate to severe disease activity (Harvey Bradshaw index \>7 or UCDAI \>6)
3. Current pregnancy or attempting to conceive
4. Known coexisting hyperparathyroidism
5. Already on vitamin D supplementation, calcium supplementation or a multivitamin
6. BMI \>30 kg/m²
7. History of kidney stones
8. Subjects \<18 years of age - pediatric population with different recommended dosing than adults (10).
9. Non-english speakers
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cedars-Sinai Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Eric Vasiliauskas

Associate Clinical Director, Inflammatory Bowel Disease Program

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Cedars Sinai Medical Center

Los Angeles, California, United States

Site Status

Countries

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United States

References

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Xavier RJ, Podolsky DK. Unravelling the pathogenesis of inflammatory bowel disease. Nature. 2007 Jul 26;448(7152):427-34. doi: 10.1038/nature06005.

Reference Type BACKGROUND
PMID: 17653185 (View on PubMed)

Ananthakrishnan AN. Epidemiology and risk factors for IBD. Nat Rev Gastroenterol Hepatol. 2015 Apr;12(4):205-17. doi: 10.1038/nrgastro.2015.34. Epub 2015 Mar 3.

Reference Type BACKGROUND
PMID: 25732745 (View on PubMed)

Cantorna MT. Vitamin D, multiple sclerosis and inflammatory bowel disease. Arch Biochem Biophys. 2012 Jul 1;523(1):103-6. doi: 10.1016/j.abb.2011.11.001. Epub 2011 Nov 10.

Reference Type BACKGROUND
PMID: 22085500 (View on PubMed)

Other Identifiers

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Pro00045446

Identifier Type: -

Identifier Source: org_study_id

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