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Very high-dose ergocalciferol is effective for correcting vitamin D deficiency in children and young adults with cystic fibrosis.
J Cyst Fibros 2009; 8(4):270-2JC

Abstract

Approximately 10-80% of patients with Cystic Fibrosis (CF) have vitamin D deficiency. Obtaining therapeutic vitamin D levels has been a challenge for CF care providers using current recommended high-dose oral ergocalciferol (400,000 IU over 2 months). The objective of this study was to evaluate the safety and efficacy of a 2-week, very high dose ergocalciferol (700,000 IU over 14 days) repletion strategy in children and young adults with CF. As part of a quality improvement initiative, a prospective cohort study was performed from January through May 2007. Phase I included identifying individuals with CF who were subtherapeutic in 25-OH D. In phase II, 50,000 IU of ergocalciferol was prescribed for a 14 day term and administered daily. During phase III, a post treatment 25-OH D level was obtained to determine improvement. Baseline demographics and clinical characteristics were obtained at study entry. Stratification of the post 25-OHD levels was defined. Eighteen individuals with CF participated in the study. The mean age was 17+/-5 years (range 6-25 years). One hundred percent were pancreatic insufficient and required pancreatic enzyme replacement. All 18 had 25-OHD levels less than 30 ng/mL pre-treatment. Seventeen of the 18 (94%) participants became therapeutic in the 2-week interval. No patients had values considered high abnormal (100-150 ng/mL) or toxic (>150 ng/mL). Mean change was noted at an increase of 37.3+/-22 ng/mL in the 2-week period (p<0.001). Pre and peripubertal individuals had a significantly greater increase in 25-OH D levels. The results of this study demonstrate that very high dosing of vitamin D using oral ergocalciferol over a 14 day period is an effective strategy in achieving therapeutic levels of 25-OH vitamin D in children and young adults with CF. We believe this regimen deserves further study.

Authors+Show Affiliations

Cystic Fibrosis Center of Chicago, 2401 Ravine Way, Suite 302, Glenview. Illinois 60025, USA. sboas@wecare4lungs.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase I
Clinical Trial, Phase II
Journal Article

Language

eng

PubMed ID

19447079

Citation

Boas, Steven R., et al. "Very High-dose Ergocalciferol Is Effective for Correcting Vitamin D Deficiency in Children and Young Adults With Cystic Fibrosis." Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society, vol. 8, no. 4, 2009, pp. 270-2.
Boas SR, Hageman JR, Ho LT, et al. Very high-dose ergocalciferol is effective for correcting vitamin D deficiency in children and young adults with cystic fibrosis. J Cyst Fibros. 2009;8(4):270-2.
Boas, S. R., Hageman, J. R., Ho, L. T., & Liveris, M. (2009). Very high-dose ergocalciferol is effective for correcting vitamin D deficiency in children and young adults with cystic fibrosis. Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society, 8(4), pp. 270-2. doi:10.1016/j.jcf.2009.04.004.
Boas SR, et al. Very High-dose Ergocalciferol Is Effective for Correcting Vitamin D Deficiency in Children and Young Adults With Cystic Fibrosis. J Cyst Fibros. 2009;8(4):270-2. PubMed PMID: 19447079.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Very high-dose ergocalciferol is effective for correcting vitamin D deficiency in children and young adults with cystic fibrosis. AU - Boas,Steven R, AU - Hageman,Joseph R, AU - Ho,Louisa T, AU - Liveris,Marissa, Y1 - 2009/05/15/ PY - 2009/02/27/received PY - 2009/03/17/revised PY - 2009/04/03/accepted PY - 2009/5/19/entrez PY - 2009/5/19/pubmed PY - 2009/9/24/medline SP - 270 EP - 2 JF - Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society JO - J. Cyst. Fibros. VL - 8 IS - 4 N2 - Approximately 10-80% of patients with Cystic Fibrosis (CF) have vitamin D deficiency. Obtaining therapeutic vitamin D levels has been a challenge for CF care providers using current recommended high-dose oral ergocalciferol (400,000 IU over 2 months). The objective of this study was to evaluate the safety and efficacy of a 2-week, very high dose ergocalciferol (700,000 IU over 14 days) repletion strategy in children and young adults with CF. As part of a quality improvement initiative, a prospective cohort study was performed from January through May 2007. Phase I included identifying individuals with CF who were subtherapeutic in 25-OH D. In phase II, 50,000 IU of ergocalciferol was prescribed for a 14 day term and administered daily. During phase III, a post treatment 25-OH D level was obtained to determine improvement. Baseline demographics and clinical characteristics were obtained at study entry. Stratification of the post 25-OHD levels was defined. Eighteen individuals with CF participated in the study. The mean age was 17+/-5 years (range 6-25 years). One hundred percent were pancreatic insufficient and required pancreatic enzyme replacement. All 18 had 25-OHD levels less than 30 ng/mL pre-treatment. Seventeen of the 18 (94%) participants became therapeutic in the 2-week interval. No patients had values considered high abnormal (100-150 ng/mL) or toxic (>150 ng/mL). Mean change was noted at an increase of 37.3+/-22 ng/mL in the 2-week period (p<0.001). Pre and peripubertal individuals had a significantly greater increase in 25-OH D levels. The results of this study demonstrate that very high dosing of vitamin D using oral ergocalciferol over a 14 day period is an effective strategy in achieving therapeutic levels of 25-OH vitamin D in children and young adults with CF. We believe this regimen deserves further study. SN - 1873-5010 UR - https://www.unboundmedicine.com/medline/citation/19447079/Very_high_dose_ergocalciferol_is_effective_for_correcting_vitamin_D_deficiency_in_children_and_young_adults_with_cystic_fibrosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1569-1993(09)00033-2 DB - PRIME DP - Unbound Medicine ER -