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Higher 25‐hydroxyvitamin D levels are associated with greater odds of remission with anti‐tumour necrosis factor‐ α medications among patients with inflammatory bowel diseases
Author(s) -
Winter R. W.,
Collins E.,
Cao B.,
Carrellas M.,
Crowell A. M.,
Korzenik J. R.
Publication year - 2017
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13936
Subject(s) - medicine , inflammatory bowel diseases , gastroenterology , odds ratio , inflammatory bowel disease , tumor necrosis factor alpha , necrosis , odds , risk factor , tumor necrosis factor α , logistic regression , disease
Summary Background Vitamin D has been linked to disease activity among patients with inflammatory bowel diseases ( IBD ). Prior investigation has also suggested that vitamin D levels may affect duration of therapy with anti‐tumour necrosis factor‐α (anti‐ TNF ‐α) medications among patients with IBD . Aim To evaluate the relationship between vitamin D levels and odds of reaching remission while on an anti‐ TNF ‐α medication. Methods A total of 521 IBD patients enrolled in the Brigham and Women's IBD Centre database were eligible for inclusion. Patients treated with anti‐ TNF ‐α therapy who had vitamin D levels drawn within 6 months prior or 2 weeks after initiation of anti‐ TNF ‐ α medication and who had reported remission status at 3 months were included. A logistic regression model adjusting for age, gender, IBD diagnosis, anti‐ TNF ‐α medication (infliximab vs. adalimumab) and first or subsequent anti‐ TNF ‐α medication was used to identify the effect of vitamin D level on initial response to anti‐ TNF ‐α therapy. Results A total of 173 patients were included in the final analysis. On logistic regression, patients with normal vitamin D levels n = 122 at the time of anti‐ TNF ‐ α medication initiation had a 2.64 increased odds of remission at 3 months compared to patients with low vitamin D levels n = 51 when controlling for age, gender, diagnosis, type of anti‐ TNF ‐α medication and first or subsequent anti‐ TNF ‐α medication ( OR = 2.64, 95% CI = 1.31–5.32, P = 0.0067). Conclusions These findings suggest that vitamin D levels may influence initial response to anti‐ TNF ‐ α medication and that low vitamin D levels may pre‐dispose patients to decreased odds of remission.