For patients with multiple sclerosis (MS) treated with fingolimod, higher 25-hydroxyvitamin D (25[OH]D) levels are associated with a lower number of active lesions, according to results published in Neurological Sciences.
Although the results did not show a causal effect, they indicate that many patients with MS may benefit from higher 25(OH)D levels.
The study included participants with MS who started fingolimod at the San Raffaele Hospital MS center and had available baseline 25(OH)D levels. The researchers followed participants for 2 years with periodic clinical examinations and magnetic resonance imaging scans.
The researchers did not find a correlation between baseline 25(OH)D levels and annualized relapse rates or time to first relapse.
However, they did find that participants with serum 25(OH)D ≥100 nmol/L had a lower number of gadolinium-positive and combined unique activity lesions at baseline compared with participants with 25[OH]D levels<50 nmol/L (P <.05). These participants also showed fewer combined unique activity lesions after 2 years of follow-up after adjusting for baseline level of disease activity (P <.05).
“In conclusion, our data suggest a mild association between 25[OH]D levels and neuroradiologic disease activity also in patients treated with a second-line therapy,” the investigators stated. “A causal effect has not yet been shown and further studies are needed to disentangle the effect of baseline 25[OH]D levels and disease activity levels on follow-up outcomes and to explore the interaction between 25[OH]D and [fingolimod] therapy. However, given the vitamin D supplementation safety profile, most [people with] MS could probably benefit from 25[OH]D levels above those currently considered to be sufficient.”
Ferre L, Clarelli F, Sferruzza G, et al. Basal vitamin D levels and disease activity in multiple sclerosis patients treated with fingolimod [published online May 13, 2018]. Neurol Sci. doi:10.1007/s10072-018-3440-0