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Failure of high-dose ergocalciferol to correct vitamin D deficiency in adults with cystic fibrosis.
Am J Respir Crit Care Med 2005; 172(2):212-7AJ

Abstract

RATIONALE

Treatment guidelines for vitamin D monitoring and supplementation in cystic fibrosis (CF) have recently been developed and published by a consensus committee, but have not been prospectively tested.

OBJECTIVES

To use these guidelines to determine the percentage of adults with CF requiring vitamin D repletion therapy and to evaluate the effectiveness of the currently recommended high-dose oral ergocalciferol repletion protocol.

METHODS

Prospective study of clinical outcomes after therapy with the recommended vitamin D repletion algorithm.

RESULTS

Of 134 adults with CF, 109 (81.3%) were found to have 25-hydroxyvitamin D (25-OHD) levels below the recommended 30 ng/ml. Sixty-six of these adults completed the recommended course of 400,000 IU of oral ergocalciferol over 2 months, and only five (8%) responded with correction of their serum 25-OHD to the goal of 30 ng/ml or greater (mean change, +0.3 ng/ml; from 18.8 to 19.1 ng/ml). In the 33 adults with CF who also completed the recommended second course of 800,000 IU of ergocalciferol over 2 months, none demonstrated correction of their deficiency (mean change, -1.2 ng/ml).

CONCLUSION

The results of this study demonstrate that a majority of adults with CF have serum 25-OHD levels below 30 ng/ml, and the currently recommended ergocalciferol repletion regimen often does not fully correct vitamin D deficiency and may need to be revised to include even higher dosing of ergocalciferol. Further work is needed to establish the ideal 25-OHD level for maximizing calcium absorption and bone health in CF.

Authors+Show Affiliations

Johns Hopkins Adult CF Program, 1830 East Monument Street, 5th floor, Baltimore, MD 21205, USA. mboyle@jhmi.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15860755

Citation

Boyle, Michael P., et al. "Failure of High-dose Ergocalciferol to Correct Vitamin D Deficiency in Adults With Cystic Fibrosis." American Journal of Respiratory and Critical Care Medicine, vol. 172, no. 2, 2005, pp. 212-7.
Boyle MP, Noschese ML, Watts SL, et al. Failure of high-dose ergocalciferol to correct vitamin D deficiency in adults with cystic fibrosis. Am J Respir Crit Care Med. 2005;172(2):212-7.
Boyle, M. P., Noschese, M. L., Watts, S. L., Davis, M. E., Stenner, S. E., & Lechtzin, N. (2005). Failure of high-dose ergocalciferol to correct vitamin D deficiency in adults with cystic fibrosis. American Journal of Respiratory and Critical Care Medicine, 172(2), pp. 212-7.
Boyle MP, et al. Failure of High-dose Ergocalciferol to Correct Vitamin D Deficiency in Adults With Cystic Fibrosis. Am J Respir Crit Care Med. 2005 Jul 15;172(2):212-7. PubMed PMID: 15860755.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Failure of high-dose ergocalciferol to correct vitamin D deficiency in adults with cystic fibrosis. AU - Boyle,Michael P, AU - Noschese,Michelle L, AU - Watts,Sharon L, AU - Davis,Marsha E, AU - Stenner,Shane E, AU - Lechtzin,Noah, Y1 - 2005/04/28/ PY - 2005/4/30/pubmed PY - 2005/9/8/medline PY - 2005/4/30/entrez SP - 212 EP - 7 JF - American journal of respiratory and critical care medicine JO - Am. J. Respir. Crit. Care Med. VL - 172 IS - 2 N2 - RATIONALE: Treatment guidelines for vitamin D monitoring and supplementation in cystic fibrosis (CF) have recently been developed and published by a consensus committee, but have not been prospectively tested. OBJECTIVES: To use these guidelines to determine the percentage of adults with CF requiring vitamin D repletion therapy and to evaluate the effectiveness of the currently recommended high-dose oral ergocalciferol repletion protocol. METHODS: Prospective study of clinical outcomes after therapy with the recommended vitamin D repletion algorithm. RESULTS: Of 134 adults with CF, 109 (81.3%) were found to have 25-hydroxyvitamin D (25-OHD) levels below the recommended 30 ng/ml. Sixty-six of these adults completed the recommended course of 400,000 IU of oral ergocalciferol over 2 months, and only five (8%) responded with correction of their serum 25-OHD to the goal of 30 ng/ml or greater (mean change, +0.3 ng/ml; from 18.8 to 19.1 ng/ml). In the 33 adults with CF who also completed the recommended second course of 800,000 IU of ergocalciferol over 2 months, none demonstrated correction of their deficiency (mean change, -1.2 ng/ml). CONCLUSION: The results of this study demonstrate that a majority of adults with CF have serum 25-OHD levels below 30 ng/ml, and the currently recommended ergocalciferol repletion regimen often does not fully correct vitamin D deficiency and may need to be revised to include even higher dosing of ergocalciferol. Further work is needed to establish the ideal 25-OHD level for maximizing calcium absorption and bone health in CF. SN - 1073-449X UR - https://www.unboundmedicine.com/medline/citation/15860755/full_citation L2 - http://www.atsjournals.org/doi/full/10.1164/rccm.200403-387OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -