Table 1. Studies of vitamin D and Ca supplementation in sarcoidosis.
| First author | Mark J. Bolland85 | Giovanna Capolongo12 | Lieke S. Kamphuis80 | Norman H. Bell1 | ||
| Year | 2013 | 2016 | 2014 | 1979 | ||
| Design | Randomized, placebo controlled |
Non-randomized | Retrospective | Non-randomized | ||
| Number of patients | 27 | 86 | 301 | 7 | ||
| Type of patients | Normocalcemic sarcoidosis with 25-(OH)D <50 nmol |
Sarcoidosis patients with serum 25-(OH)D <75 nmol/L |
Sarcoidosis patients | 4 normocalcemic patients and 3 patients with history of hypercalcemia |
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| Age (years) | 57 | 51±6.7 | Unknown | 22–64 | ||
| Female number (%) | 19 (70%) | 15 (93.7%) | 174 (58%) | 7 (50%) | ||
| Race/ethnicity | European (77%) Indian (8%) Other (8%) |
African American (88%) Caucasian (12%) |
Unknown | |||
| Number of patients treated with vitamin D | 13 | 16 | 104 | 7 | ||
| Intervention | ||||||
|---|---|---|---|---|---|---|
| Type of vitamin D | Cholecalciferol (vitamin D3) | Ergocalciferol (vitamin D2) |
Vitamin D2 in propylene glycol was given daily as a single dose |
|||
| Dose/frequency/duration | 50,000 IU weekly for 4 weeks then monthly for 11 months |
50,000 IU once a week for 12 weeks |
10,000 IU daily for 12 days | |||
| Diet | Usual diet | Usual diet | Usual Diet | Constant metabolic diet | ||
| Glucocorticoid use | 54% past oral use 8% current oral use 46% current inhaled use |
48% US patients 47% Italian patients |
40% of hypercalcemic patients |
Unknown | ||
| Baseline laboratory parameters | Vitamin D (n = 13) |
Placebo (n = 14) |
Pre-vitamin D (n = 16) |
Ca and vitamin D supplementation (n = 104) |
Normal subjects (n = 7) |
Patients with normal Ca metabolism (n = 4) |
| 25-(OH)D (nmol/L) | 40±17 | 45±17 | 42±13 | 46 | 67.4±14.9 | 37.4±12.4 |
| 1,25-(OH)2D (pmol/L) | 109±34 | 116±25 | 94±30 | 114 | 72.±7.2 | 70±7.2 |
| Serum phosphorus (mmol/L) | 1.23±0.15 | 1.06±0.17 | 1.1 | |||
| Serum Ca (mmol/L) | 2.24±0.06 | 2.26±0.12 | 2.38±0.05 | 2.39 | 2.37±0.05 | 2.32±0.05 |
| Parathyroid hormone (pmol/L) | 4.0±1.6 | 4.9±2.0 | 5.8±3.1 | |||
| Urinary Ca (mmol/day) | 4.6±3.4 | 6.6±5.2 | 3.4±2.3 | 5.17±0.55 | 3.42±0.45 | |
| Outcome laboratory | Post-vitamin D repletion (n = 13) | Placebo (n = 14) |
Post-vitamin D repletion (n = 16) |
Ca and vitamin D supplementation (n = 104) |
Normal subjects (n = 7) |
Sarcoidosis patients with normal Ca metabolism (n = 4) |
| % hypercalcemia, n (%) | 1 (7.6%) | 0 | 1 (6.2%) | 5% (4% excluding 1 patient with primary hyperparathyroidism at baseline) |
0 | 0 |
| % hypercalciuria, n (%) | 1 (7.6%) | 0 | 2/16 (12.5%) | 0 | 0 | |
| 25-(OH)D (nmol/L) | 80 (68–93)a | 48 (34–62)a | 81±25 | 74 | 72.4±14.9 | 69.8±9.98 |
| 1,25-(OH)2D (pmol/L) | 141 (114–174)a | 127 (107–140)a |
49±21 | 74.4±4.8 | 79.2±4.8 | |
| Serum Ca (mmol/L) | 2.24 (2.19–2.30)a | 2.24 (2.18– 2.29)a |
2.40±0.15 | 4.8±0.05 | 4.8±0.2 | |
| Urinary Ca (mmol/day) | 7.3 (3.4–11.1)a | 5.3 (2.6–7.9)a |
4.2±3.3 | 4.9±0.45 | 4.15±0.62 | |
Results are expressed as mean ± SD. aData are extracted from figures in Boland et al. and expressed as mean (95% CI). 25-(OH)D, 25-hydroxyvitamin-D; 1,25-(OH)2D, 1,25-dihydroxyvitamin D; Ca, calcium