Vitamin D deficiency tied to severe disease, radiographic progression in early RA patients

In patients with early rheumatoid arthritis (RA), vitamin D deficiency is associated with more active and severe disease at baseline and is a predictor of disability and radiographic progression, suggests a study.

The authors assessed early RA patients included in the ESPOIR cohort and measured levels of 25-hydroxy vitamin D2 and D3 at baseline. They also examined baseline associations between vitamin D levels and 28-joint count Disease Activity Score based on erythrocyte sedimentation rate (DAS28-ESR), Health Assessment Questionnaire–Disability Index (HAQ-DI), and van der Heijde modified total Sharp score (mTSS).

The association between vitamin D level and radiographic progression (mTSS increased by ≥1 point) or disability (HAQ-DI ≥0.5) over 12 months was assessed using bivariate analysis, while the independent relationship of baseline variables with outcomes was examined using forward stepwise multiple logistic regression.

Of the 813 patients with early arthritis, 645 with RA had their data analysed. Vitamin D level was <10 ng/mL (deficiency, group 1) for 114 patients (17.7 percent), 10–29.9 ng/mL (low level, group 2) for 415 patients (64.54 percent), and ≥30 ng/mL (normal, group 3) for 114 patients (17.7 percent).

At baseline, early RA patients with vitamin D deficiency had higher DAS28-ESR and HAQ-DI than those in groups 2 (p=0.007) and 3 combined (p=0.001), as well as higher mean mTSS, but not significantly (p=0.076). Finally, multivariate analysis revealed the association of baseline vitamin D deficiency with HAQ-DI at 6 months (odds ratio [OR], 1.70) and with mTSS at 12 months (OR, 1.76).

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