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Clinical Orthopaedics and Related Research®

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01-11-2013 | Clinical Research

Does Vitamin D Improve Osteoarthritis of the Knee: A Randomized Controlled Pilot Trial

Authors: Divya Sanghi, PhD, Abhishek Mishra, MSc, Amar Chandra Sharma, MSc, Ajai Singh, MS, S. M. Natu, PhD, Sarita Agarwal, PhD, Rajeshwar Nath Srivastava, MS

Published in: Clinical Orthopaedics and Related Research® | Issue 11/2013

Abstract

Background

Animal, epidemiologic, and human clinical studies suggest a putative role for vitamin D in osteoarthritis (OA). Inadequate sunlight exposure and lower serum levels of 25(OH)D appear in some reports to be associated with an increased risk for progression of knee OA.

Questions/purposes

We asked whether treatment with vitamin D would (1) reduce knee pain (WOMAC and VAS), (2) improve function (WOMAC), and (3) change levels of relevant biochemical markers in patients with knee OA with vitamin D insufficiency.

Methods

This randomized controlled pilot trial prospectively enrolled 107 patients with knee OA with vitamin D insufficiency (25(OH)D ≤ 50 nmol/L) to receive oral vitamin D or placebo. The primary outcome measures were pain and function, and the secondary were biochemical markers. At baseline, the two groups were comparable. The patients were followed for 1 year.

Results

At 12 months, knee pain had decreased in the vitamin D group by mean −0.26 (95% CI, −2.82 to −1.43) on VAS and −0.55 (95% CI, −0.07 to 1.02) on the WOMAC, whereas in the placebo group, it increased by mean 0.13 (95% CI, −0.03 to 0.29) on the VAS and 1.16 (95% CI, 0.82 to 1.49) on the WOMAC (effect size = 0.37 and 0.78). Likewise knee function improved in the vitamin D group by mean −1.36 (95% CI, −1.87 to −0.85) over the placebo group which had a mean 0.69 (95% CI, −0.03 to 1.41; effect size = 0.06). There were significant biochemical changes in serum total calcium, 25(OH)D and alkaline phosphatase.

Conclusions

The results above suggest there is a small but statistically significant clinical benefit to vitamin D treatment in patients with knee OA, although we recommend a long-term study to determine whether these changes are clinically important and whether they will be sustained with time. Further studies with long-term radiologic evaluations are needed.

Level of Evidence

Level I, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.

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Title: Does Vitamin D Improve Osteoarthritis of the Knee: A Randomized Controlled Pilot Trial
Authors: Divya Sanghi, PhD
Abhishek Mishra, MSc
Amar Chandra Sharma, MSc
Ajai Singh, MS
S. M. Natu, PhD
Sarita Agarwal, PhD
Rajeshwar Nath Srivastava, MS
Publication date: 01-11-2013
Publisher: Springer US
Published in: Clinical Orthopaedics and Related Research® / Issue 11/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-013-3201-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Does Vitamin D Improve Osteoarthritis of the Knee: A Randomized Controlled Pilot Trial

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

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