Prospective Intervention Study on Vitamin D in Patients With Cystic Fibrosis (D-vitamin)
Recruitment status was Recruiting
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Purpose
The vast majority of Cystic Fibrosis (CF) patients worldwide are vitamin D insufficient. There is no evidence of benefit of vitamin D supplementation for CF patients yet. However, descriptive cross-sectional studies suggest that vitamin D might be beneficial with respect to bone health, as well as to the newly described "non-classical" functions of vitamin D such as the potential anti-diabetic and immunomodulatory effects. To prove causation, and to determine which serum vitamin D concentration is optimal for CF patients, vitamin D supplementation interventional studies are needed, such as our trial.
| Condition | Intervention | Phase |
|---|---|---|
|
Cystic Fibrosis |
Dietary Supplement: Supplementation with vitamin D2/D3 |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | 5-month Pilot Intervention Study on Vitamin D in Patients With Cystic Fibrosis |
- Serum 25-hydroxy vitamin D [ Time Frame: 3 months ] [ Designated as safety issue: No ]This pilot study is primarily designed for establishing effective vitamin D dosing in our specific patient population, and only secondarily designed (and thus, not powered for) for the secondary outcome measures. The results of this study will make it possible for the first time to power the follow-up long-term study for some of the secondary outcome measures followed in this pilot study, some of which might therefore become primary outcome measures in the follow-up study.
- Parathyroid hormone (PTH) [ Time Frame: 3 months ] [ Designated as safety issue: No ]As a surrogate marker of bone health
- Inflammatory parameters [ Time Frame: 3 months ] [ Designated as safety issue: No ]Cytokine profiles, antimicrobial peptides, peripheral blood mononuclear cell profiles, immunoglobulines, acute phase markers, sedimentation rate and other
- Infection parameters [ Time Frame: 3 months ] [ Designated as safety issue: No ]Number of days on intravenous antibiotic treatment; number of infectious episodes; number of common cold episodes; relative number of sputum samples positive for pathological bacteria; and other
- Lung function parameters [ Time Frame: 3 months ] [ Designated as safety issue: No ]FEV1, FVC, PEF, FEF25, FEF50, FEF75 and other
- Glucose tolerance parameters [ Time Frame: 3 months ] [ Designated as safety issue: No ]Insulin, C-peptide, glucagon, fasting plasma glucose, HbA1c, 3-hour 75-g oral glucose tolerance test
- Adherence with vitamin D treatment [ Time Frame: 3 months ] [ Designated as safety issue: No ]Semi-quantitative assessment by a questionnaire (thus, a patient-reported outcome)
- Disease-specific quality of life [ Time Frame: 3 months ] [ Designated as safety issue: No ]Assessment using "CFQ-R" questionnaire, specifically designed to measure the quality of life in CF patients
- Plasma calcium [ Time Frame: 3 months ] [ Designated as safety issue: Yes ]Proportion of patients with albumin-corrected serum calcium increasing to a concentration greater than 2,75 mmol/L in patients with no hypercalcaemia before vitamin D supplementation was started.
- Relative number of patients reaching high abnormal 25(OH)D concentrations [ Time Frame: 3 months ] [ Designated as safety issue: Yes ]Proportion of patients in the intervention arms reaching 25(OH)D >250 nmol/L
- Proportion of patients reaching toxic 25(OH)D concentrations [ Time Frame: 3 months ] [ Designated as safety issue: Yes ]Proportion of patients in the intervention arms reaching 25(OH)D >375 nmol/L
- Proportion of patients with suspect hypercalcaemia symptoms [ Time Frame: 3 months ] [ Designated as safety issue: Yes ]Proportion of patients with suspect hypercalcaemia symptoms in the intervention arms
| Estimated Enrollment: | 15 |
| Study Start Date: | April 2010 |
| Estimated Primary Completion Date: | September 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Ergocalciferol
Patients younger than 16 years of age are administered 35,000 IU ergocalciferol per week divided into doses 5000 IU per day as a starting dose that is further adjusted by serum 25-hydroxy vitamin D concentration monitoring. Patients 16 or more years of age are administered 50,000 IU ergocalciferol per week divided into doses 7150 IU per day as a starting dose that is further adjusted by serum 25-hydroxy vitamin D concentration monitoring. |
Dietary Supplement: Supplementation with vitamin D2/D3
Patients younger than 16 years of age are administered 35,000 IU ergo-/chole-calciferol per week divided into doses 5000 IU per day as a starting dose that is further adjusted by serum 25-hydroxy vitamin D concentration monitoring. The intervention time is 3 months, followed by 2-months wash-out period when patients do not take any more extra vitamin D but they are still monitored. Patients 16 or more years of age are administered 50,000 IU ergo-/chole-calciferol per week divided into doses 7150 IU per day as a starting dose that is further adjusted by serum 25-hydroxy vitamin D concentration monitoring. |
|
Experimental: Cholecalciferol
Patients younger than 16 years of age are administered 35,000 IU cholecalciferol per week divided into doses 5000 IU per day as a starting dose that is further adjusted by serum 25-hydroxy vitamin D concentration monitoring. Patients 16 or more years of age are administered 50,000 IU cholecalciferol per week divided into doses 7150 IU per day as a starting dose that is further adjusted by serum 25-hydroxy vitamin D concentration monitoring. |
Dietary Supplement: Supplementation with vitamin D2/D3
Patients younger than 16 years of age are administered 35,000 IU ergo-/chole-calciferol per week divided into doses 5000 IU per day as a starting dose that is further adjusted by serum 25-hydroxy vitamin D concentration monitoring. The intervention time is 3 months, followed by 2-months wash-out period when patients do not take any more extra vitamin D but they are still monitored. Patients 16 or more years of age are administered 50,000 IU ergo-/chole-calciferol per week divided into doses 7150 IU per day as a starting dose that is further adjusted by serum 25-hydroxy vitamin D concentration monitoring. |
|
No Intervention: Control
Patients continue their ordinary vitamin supplementation without getting extra vitamin D supplements.
|
Eligibility| Ages Eligible for Study: | 6 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Established diagnosis of cystic fibrosis
- Age 6 years and more
- Serum 25-hydroxy vitamin D concentration at the latest visit < 75 nmol/L
Exclusion Criteria:
- Pregnancy or lactation
- Established diagnosis of CF-related diabetes
- CF-related liver disease
- Status post transplantation (lung, liver or other)
- Long-term corticosteroid treatment per os
- Hypercalcaemia or kidney stones
- Use of tanning beds more often than once a month
- At inclusion, plans to travel to a sunny location for more than 1 week during the study period
- Any known disorders of the endocrine system affecting vitamin D metabolism (hyperparathyroidism, malignancy, advanced renal disease)
- Inclusion into another study testing immunomodulatory substances
Contacts and Locations| Contact: Terezia Pincikova, MD | + 46 8 585 81483 | Terezia.Pincikova@karolinska.se |
| Sweden | |
| Stockholm Cystic Fibrosis Center, Karolinska University Hospital Huddinge | Recruiting |
| Stockholm, Sweden, 141 86 | |
| Contact: Lena Hjelte, Professor 0046858587359 Lena.Hjelte@karolinska.se | |
More Information
No publications provided
| Responsible Party: | Amélie Theorell (Rector's secretary), Karolinska Institutet |
| ClinicalTrials.gov Identifier: | NCT01321905 History of Changes |
| Other Study ID Numbers: | 2009/1723-31/1 |
| Study First Received: | March 23, 2011 |
| Last Updated: | March 23, 2011 |
| Health Authority: | Sweden: Regional Ethical Review Board |
Additional relevant MeSH terms:
|
Cystic Fibrosis Fibrosis Pancreatic Diseases Digestive System Diseases Lung Diseases Respiratory Tract Diseases Genetic Diseases, Inborn Infant, Newborn, Diseases Pathologic Processes |
Cholecalciferol Ergocalciferols Vitamin D Vitamins Micronutrients Growth Substances Physiological Effects of Drugs Pharmacologic Actions Bone Density Conservation Agents |
ClinicalTrials.gov processed this record on May 19, 2013