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Abstract

Background : Low level of vitamin D impact the disease activity and the degree of fatigue in SLE patients. This study aims to determine the effect of vitamin D supplementation on disease activity and fatigue condition in Systemic Lupus Erythematosus (SLE) patients with hipovitamin D.

Methods: We performed an open clinical trial. Subjects were randomized into two different groups (supplementation or placebo) using simple random sampling. The treatment group got vitamin D3 softgel/ cholecalciferol 1200 IU/day or 30 mg/day, while the control group gotplacebo for 3 months. SLEDAI scores and FSS scores were calculated at pre and post
treatment.

Results: There were 20 subjectsfor supplementation group and 19 subjects in the placebo group. From this study, before and after treatment, we found a significant difference of mean level of vitamin D in supplementation group (p=0.000), and no significant difference in
patients with placebo (p=0.427). Moreover, from the SLEDAI score analysis, observed a significant difference bothin the supplemented group (p=0.000) and the placebo group (p=0.006). FSS scores significantly different in the supplemented group (p=0.000). In
correlation test,there was a negative correlation (r=-0763) between vitamin D level and disease activity (SLEDAI), and both showing stastistical significance between thepre supplementation (p=0.000) and post supplementation (r=-0846; p=0.000). Similarly to the
FSS scores, there was a meaningfulnegative correlation (r=-0.931, p=0.000) between the level of vitamin D with FSS scores pre and post supplementation (r=-0.911; p= 0.000). Furthermore, there was a significant correlation between disease activity (SLEDAI) pre supplementation with fatigue condition pre supplementation (r=0.846; p = 0.000) and post
supplementation (r=0.913; p= 0.000).

Conclusion: The supplementation of vitamin D 1200 IU per day in patients with SLE improve disease activity and degree of fatigue.

Keywords: vitamin D, disease activity, fatigue, SLE

Article Details

How to Cite
Rifa’iA., Kalim, H., Kusworini, K., & Wahono, C. S. (2018). Effect of vitamin D supplementation on disease activity (SLEDAI) and fatigue in Systemic Lupus Erythematosus patients with hipovitamin D: An Open Clinical Trial. Indonesian Journal of Rheumatology, 8(2). https://doi.org/10.37275/ijr.v8i2.59

References

  1. Handono K. HLA kelas II dan kerentanan genetic terhadap lupus eritematosus sistemik di Indonesia. Acta Med Ind. 2000; 32: 11-15.
  2. Costendaber KH, Feskanich D, Holmes M, Karlson EW, Benito-Garcia E. Vitamin D intake and risk of systemic lupus erythematosus and rheumatoid arthritis in women. Ann Rheum Dis 2008; 67(4):530-535.
  3. Chen S, Sims GP, Chen XX, Gu YY, Chen S, Lipsky PE. Modulatory effects of 1,25-dihydroxyvitamin D 3 on human B cell differentiation. J Immunol. 2007 Aug 1; 179(3) :1634-1647.
  4. Leni P. Korelasi kadar vitamin D serum dengan aktifitas penyakit lupus eritematosus sistemik (Final Scription;Unpublished). 2012.
  5. Irastorza GR, Egurbide MV, Olivares N, Martinez-Berriotxoa A, Aguirre C. Vitamin D deficiency in systemic lupus erythematosus: prevalence,
  6. predictors and clinical consequences. Rheumatology. 2008; 47: 920-923. 6. Tench CM, McCurdie I, White PD, D’Cruz DP.The prevalence and associations of fatique in SLE. Rheumatology (Oxford). 2000; 39(11):1249-1254.
  7. Ruiz-Irastorza G, Gordo S, Olivares N, Egurbide MV, Aguirre C. Change vitamin D level in patient with systemic lupus erytematosus: effect on fatique, disease activity damage. Arthritis Care Res (Hoboken). 2010Aug; 62(8): 1160-1165.
  8. SautoMID, Coelho A, Guo C, et al. Vitamin D insufficiency in Brazilian patients with SLE:prevalence, associated factors, and relationship with activity. Lupus J 2010; 20: 1019-1026.
  9. Cannel JJ, Hollis BW, Zasloff M, Heaney RP. Diagnosis and treatment of vitamin D deficiency. Expert Opin Pharmacother. 2008 Jan;9(1):107-118.
  10. Raya AA, Helmii M, Raya SA. The Effect of Vitamin D Supplementation on Inflammatory and Hemostatic Markers and Disease Activity in Patients with Systemic Lupus Erythematosus: A Randomized Placebocontrolled Trial. J Rheumatol. 2013 Mar; 40(3):265-72. DOI: 10.3899/ jrheum.111594
  11. Reinhold V. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J ClinNutr. 1999; 69: 842–56
  12. Holic MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. J ClinNutr. 2008;87(suppl):S1080– 1086
  13. Petri M, Bello KJ, Fang H, Magder LS. Vitamin D in systemic lupus erythematosus modest association with disease activity and the urine protein-to-creatinine ratio. Arthitis& Rheumatism. July 2013; 65 (7): 1865–1871
  14. Borba VZC, Vieira JGH, Kasamatsu T, Radominski SC, Sato EI, LazarettiCastro. Vitamin D deficiency in patients with active systemic lupus erythematosus. Osteoporosis International 2009; 20(3): 427-433.
  15. Thudi A, Yin S, Wandstrat AE,et al. Vitamin D levels and disease status in Texas patients with lupus erythematosus. Am J Med Sci: 2008; 335: 99-104
  16. Chapuy MC, Preziosi P, manner M, et al. prevalence of vitamin D insufficiency in adult normal population. osteoporosint 1997;7(5):439-43
  17. Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ. Prevalence of vitamin D deficiency among healthy adolosences. Arch Pediatr Adolesc Med. June 2004; 158(6) :531-537.
  18. Rucker D, Allan JA, Fick GH, Hanley DA. Vitamin D insufficiency in a population of healthy western Canadian. CMAJ. 2002;166(12);1517-1524.
  19. Valebj K, Knutsen RG, Mette B, et al, Vitamin D status in patients with musculoskeletal pain, fatigue and headache: A cross-sectional descriptive study in a multi-ethnic general practice in Norway. Scandinavian Journal of Primary Health Care. 2010; 28: 166–171
  20. Ad Hoc committee on systemic lupus erythematosus response criteria for fatigue. Measurement of Fatigue in Systemic Lupus Erythematosus : A Systemic Review. Arthritis & Rheumatism. 2007: 57(8): 1348-1357
  21. Neuerger GB. Measures of Fatigue. Arthritis& Rheumatism 2003: 49(5S): 175-183.
  22. Lorentzen K, Danielsen MA, Kay SD, Voss A. Validation of the fatigue severity scale in danish patients with systemic lupus erythematosus. Dan Med J. 2014;61(4):A 4808
  23. Stockton KA and Kandiah. Fatigue, muscle strength and vitamin D status in women with systemic lupus erythematosus compared with healthy controls. Lupus. 2012; 21(3):271-8.
  24. Zonana-Nacach A, Roseman JM, McGwin G, Friedman AW, Baethge BA, Reveille JD, et al. Systemic lupus erythematosus in three ethnic groups. VI: Factors associated with fatigue within 5 years of criteria diagnosis. Lupus. 2000; 9: 101–109
  25. Tayer WG, Nicassio PM, Weisman MH, Schuman C, Daly J. Disease status predicts fatigue in systemic lupus erythematosus. J Rheumatol. 2001: 1999–2007.
  26. Tench CM, Bentley D, Vleck V, McCurdie I, White P, D’CruzD.Aerobic fitness, fatigue, and physical disability in systemic lupus erythematosus. J Rheumatol. 2002;29: 474–81.
  27. Mattsson M, Moller B, Lundberg IE, Gard G, Bostrom C. Reliability and validity of the fatigue Severity Scale in Swedish for patients with systemic lupus erythematosus. Scand J Rheumatol. 2008; 37: 269–77
  28. Burgos PI, Alacron GS, McGwin G, Crews KQ, Reveille JD, Vila LM. Disease activity and damage are not associated with increased levels of fatigue in systemic lupus erythematosus patients from a multiethnic cohort: LXVII. Arthritis Rheum. 2009; 61: 1179–1186.
  29. Da Costa D, Dritsa M, Bernatsky S, Pineau C, Ménard HA, Dasgupta K, et al. Dimensions of fatigue in systemic lupus erythematosus: Relationship to disease status and behavioral and psychosocial factors. J Rheumatol.2006 Jul;33(7):1282-8.
  30. McKinley PS, Ouellette SC, Winkel GH. The contributions of disease activity, sleep patterns, and depression to fatigue in systemic lupus erythematosus. Arthritis Rheum. 1995; 38: 826–834.
  31. Wang B, Gladman DD, Urowitz MB. Fatiguein lupus is not correlated with disease activity. J Rheumatol. 1998; 25(5):892-5.
  32. Hathcock JN, Andrew S, Reinhold V, Robert H. Risk assessment for vitamin D. Am J ClinNutr. 2007; 85:6-18