A Clinical Trial questions Can Vitamin D Prevent a Relapse of Tuberculosis?

A clinical trial has explored the effectiveness of using vitamin D supplementation as a treatment option for pulmonary tuberculosis.

Tuberculosis (TB) is a debilitating disease and a major global public health problem. A total of 1.5 million people died from TB in 2020. Worldwide, TB is the 13th leading cause of death and the second leading infectious killer after COVID-19  and above HIV/AIDS. It is a highly contagious bacterial infection that primarily affects the lungs. It is spread through the air when an infected person coughs or sneezes. The standard treatment for TB involves a combination of drugs that must be taken for several months. However, relapse is a common problem, and some patients may require repeated treatment.

Vitamin D, also called cholecalciferol, is a micronutrient that is recognized primarily for its role in bone mineralization. It has also been under scrutiny lately concerning its effects on the immune system. In recent years, extensive research has been done to look for other functions of vitamin D. Many clinical studies have shown an inverse relationship between the levels of vitamin D and the incidence of various infectious and chronic diseases.

Clinical Trial

A clinical trial studied the effects of vitamin D3 supplementation on the prevention of relapse in drug-sensitive pulmonary tuberculosis (PTB) patients.

The trial involved 846 TB patients who were randomized into two groups – one group received standard TB treatment plus vitamin D3 supplementation, while the other group received standard TB treatment plus a placebo. The vitamin D3 group received oral vitamin D3 (60,000 IU/sachet weekly for the first two months, fortnightly for the next four months followed by monthly for the next 18 months) while the placebo group received an identical-looking tablet without any vitamin D3. The primary outcome was relapse of PTB and secondary outcomes were time to conversion of sputum smear and sputum culture.

Among the 697 who were cured of PTB, relapse occurred in 14 participants from the vitamin D group and 19 participants from the placebo group. Similarly, no statistically significant difference was seen in time to sputum smear and sputum culture conversion between both groups. There were 5 deaths in each group however, none of them were related to the trial intervention.

Findings

The findings of this clinical trial suggest that there was no significant difference in the relapse rate or the time to sputum smear or sputum culture conversion between the two groups. Hence, there were no beneficial effects of vitamin D in these tuberculosis patients.

The findings of this study have important implications for the treatment of TB. Relapse is a significant problem in TB management, and anything that can reduce the risk of relapse is welcome news. However, vitamin D3 supplementation could not be confirmed as an effective treatment option for preventing TB relapse.

Conclusion

The results of this clinical trial do not support the use of vitamin D3 supplementation as a complementary therapy for drug-sensitive pulmonary tuberculosis patients. The findings suggest that vitamin D3 does not reduce the risk of relapse, and neither does it improve treatment outcomes.
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