Vitamin D Effect in Rheumatoid Arthritis.

NCT ID: NCT04472481

Last Updated: 2020-07-15

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

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-09-06

Study Completion Date

2020-03-22

Brief Summary

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Regulatory T (Tregs) cells play an important role in the maintenance of immunological tolerance. It decrease in the peripheral blood of rheumatoid arthritis patients. Vitamin D has an immunomodulatory and anti-inflammatory effect in rheumatoid arthritis.

Vitamin D supplementation significantly enhances Tregs percentage in the peripheral blood of RA patients. So supplementation of Vit D improves rheumatoid arthritis disease activity.

Detailed Description

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Background: Regulatory T cells (Tregs) play an important role in the maintenance of immunological tolerance, so Tregs deficiency or decrease suppressor functions may be associated with development of autoimmune diseases.

Vitamin D is essential for normal bone mineralization and growth, prevention of osteopenia, osteoporosis, and nonspecific painful musculoskeletal conditions . Vitamin D is thought to have an immunomodulatory and anti-inflammatory actions, as its receptors are widely expressed in peripheral mononuclear blood cells, also its deficiency associated with several autoimmune disorders, including rheumatoid arthritis

Methods: 40 patients with active RA were randomly assigned into two groups. Group I received MTX plus hydroxychloroquine, group II received MTX and hydroxychloroquine plus vitamin D supplementation for 3 months, in addition to 30 healthy volunteers as control group. Peripheral blood Tregs were measured by Flow Cytometry.

Statistical Analysis. The collected data analyzed by SPSS software (version 16). The range, mean and standard deviation were calculated for quantitative variables. Categorical variables were expressed as number and percentages; Chi square was used as a test of their significance. Skewness, kurtosis; Shapiro-Wilk, and The Kolmogorov-Smirnov tests were used to test the normality for the data. The difference between two means was analyzed using the students (t) test (paired and unpaired samples- T tests). Significance was considered at p\<0.05.

Conditions

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Active Rheumatoid Arthritis

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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group II

50000 IU of Vitamin D2 (Ergocalciferol 1.25 mg tablet) weekly for 3 months

Group Type OTHER

Ergocalciferol 1.25 mg tablet

Intervention Type DRUG

weekly 50000 IU of Vitamin D2 (Ergocalciferol 1.25 mg tablet) given orally group II

Interventions

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Ergocalciferol 1.25 mg tablet

weekly 50000 IU of Vitamin D2 (Ergocalciferol 1.25 mg tablet) given orally group II

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* disease duration less than 3 years from the time of diagnosis, age more than 18 years, a diagnosis of RA according to the 2010 ACR/ EULAR Classification criteria for RA diagnosis , active disease according to DAS-28, for those receiving nonsteroidal anti-inflammatory drugs and corticosteroids, the dosage had to be stable for at least 2 weeks before screening.

Exclusion Criteria

* Patients with allergic, and infectious diseases, patients receiving steroids for the first time within 2 weeks before the study, patients with hypercalcemia, hypercalciuria, nephrolithiasis, or neoplastic diseases were excluded from the study. We also excluded patients on any biologic therapy and patients with prior use of leflunomide, hydroxychloroquine, or sulphasalazine for more than 2 months.
Minimum Eligible Age

33 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Tanta University

OTHER

Sponsor Role lead

Responsible Party

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Souzan Ezzat Gado

Lecturer of Rheumatology,physical medicine &Rehabilitation.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Souzan E Gado, MD

Role: PRINCIPAL_INVESTIGATOR

Lecturer

Hanaa S EL-banna, MD

Role: PRINCIPAL_INVESTIGATOR

Lecturer

Locations

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Souzan Ezzat Gado

Tanta, EL-gharbia, Egypt

Site Status

Countries

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Egypt

References

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Wang Z, Chang C, Lu Q. Epigenetics of CD4+ T cells in autoimmune diseases. Curr Opin Rheumatol. 2017 Jul;29(4):361-368. doi: 10.1097/BOR.0000000000000393.

Reference Type BACKGROUND
PMID: 28362657 (View on PubMed)

Lan Q, Fan H, Quesniaux V, Ryffel B, Liu Z, Zheng SG. Induced Foxp3(+) regulatory T cells: a potential new weapon to treat autoimmune and inflammatory diseases? J Mol Cell Biol. 2012 Feb;4(1):22-8. doi: 10.1093/jmcb/mjr039. Epub 2011 Nov 22.

Reference Type BACKGROUND
PMID: 22107826 (View on PubMed)

El-Banna HS, Gado SE. Vitamin D: does it help Tregs in active rheumatoid arthritis patients. Expert Rev Clin Immunol. 2020 Aug;16(8):847-853. doi: 10.1080/1744666X.2020.1805317. Epub 2020 Aug 25.

Reference Type DERIVED
PMID: 32783547 (View on PubMed)

Other Identifiers

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33846

Identifier Type: -

Identifier Source: org_study_id

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