Comparison of two vitamin D supplementation strategies in children with sickle cell disease: a randomized controlled trial. (10th November 2020)

• Record Type: Journal Article
• Authors: Grégoire‐Pelchat, Pascale; Pastore, Yves; Robitaille, Nancy; LeMay, Sylvie; Khamessan, Ali; Kleiber, Niina; Nyalendo, Carine; Gagné, Nancy; Alos, Nathalie; Mailhot, Geneviève
• Is Part Of: British journal of haematology. Volume 192:Number 2(2021)
• Page Start: 385
• Page End: 394
• Publication Date: 2020-11-10
• Subjects: vitamin D -- supplementation -- bolus -- children -- sickle cell disease; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.17119
• Languages: English
• ISSNs: 0007-1048

Abstract

Summary: Previously, we showed that nearly 70% of children followed in our sickle cell disease (SCD) clinic were vitamin D‐ deficient and had low vitamin intake with poor use of supplements. We compared the change in serum 25‐hydroxyvitamin D [25(OH)D], safety and clinical impact of two vitamin D supplementation regimens in children with SCD. Children (5–17 years, all genotypes) were randomized to a single bolus of vitamin D3 (300 000 IU; n = 18) or placebo ( n = 20). All children received a prescription for daily 1 000 IU vitamin D3 . Serum 25(OH)D and calcium, urinary calcium/creatinine ratio, musculoskeletal pain, quality of life, haematology and bone markers were assessed at baseline and three months post intervention. Bolus administration led to a greater rise in 25(OH)D levels from baseline compared to placebo (20 ± 16 nmol/l vs. 2 ± 19 nmol/l; P = 0·003) and correction of vitamin D deficiency. No hypercalcaemia nor hypercalciuria occurred during the study, but more children in the bolus group experienced gastrointestinal symptoms within the first month ( P = 0·04). There were no differences between groups for other outcomes. The use of a high‐dose vitamin D bolus combined with daily 1 000 IU vitamin D3 was more efficient in raising 25(OH)D levels than daily supplementation alone in children with SCD.