High-dose vitamin D delayed progression from CIS to MS in study

High-dose vitamin D can almost double the time it takes for a patient with clinically isolated syndrome (CIS) to experience further disease activity, according to a new clinical trial.

CIS is the first manifestation of symptoms that are suggestive of multiple sclerosis (MS). The French study’s results were presented at the recent European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) annual meeting.

The researchers tested to see if high-dose cholecalciferol, a type of vitamin D the skin produces when exposed to sunlight, could delay a patient’s conversion from CIS to MS.

The study looked at 303 adults, with a median age of 34, who had experienced a CIS episode within the past 90 days (about three months). The majority (70%) were women, and all had low levels of vitamin D.

These patients were initially diagnosed with CIS using older criteria. However, with the updated McDonald criteria introduced in 2017, roughly 89% of them would now qualify for a diagnosis of relapsing-remitting MS (RRMS).

Participants were randomly split into two groups. One group took 100,000 IU of cholecalciferol (vitamin D) every two weeks, while the other group received a placebo. This continued for up to two years. The main goal was to see how many patients showed signs of disease activity, which included relapses, new or growing lesions, or active inflammation visible on MRI scans.

The findings showed that high doses of cholecalciferol lowered the number of patients with disease activity by 34% compared to the placebo (60.3% vs. 74.1%). Patients on high-dose cholecalciferol also took nearly twice as long to show signs of disease activity (432 vs. 224 days).

When looking at specific disease markers, the researchers found that cholecalciferol significantly reduced new or growing lesions and inflammatory lesions, but didn’t affect relapses. The supplements also didn’t have a significant impact on disability, cognitive ability, quality of life, fatigue, anxiety, or depression.

These results stayed consistent even after considering factors like age, sex, and the number of lesions seen on initial MRIs. Additionally, those who would now be classified as having early RRMS saw similar benefits, suggesting vitamin D supplements may be helpful in this group as well.

The patients who benefited the most were those with no spinal cord lesions, very low vitamin D levels, and a normal body mass index (BMI) at the start of the study.

These encouraging new data support further studies of high-dose vitamin D supplementation as an add-on therapy in early MS, the researchers said.

Find all you need to know about vitamin D and MS in our Choices booklet.