Can Vitamin D Reduce Glucocorticoid-Induced Adverse Effects in Patients with Giant Cell Arteritis? Results from 1568 Patients in the Spanish ARTESER Registry
Year: 2025
Type: article
Study design: Observational Study
Abstract: Objective: To determine whether oral vitamin D supplementation reduces the risk of glucocorticoid (GC)-associated severe adverse events (SAEs) in patients with giant cell arteritis (GCA) included in the Spanish ARTESER registry. Methods: The ARTESER registry collected data from patients diagnosed with GCA across 26 Spanish public hospitals between June 2013 and March 2019. SAEs were defined as fatal, life-threatening, or requiring hospitalization. Patients were categorized according to the use or non-use of oral vitamin D supplements. Incidence rates (IRs) of SAEs were expressed per person-year with 95% confidence intervals (CIs). Cox proportional hazards models assessed vitamin D supplementation and its interaction with cumulative glucocorticoid dose. Results: Of 1568 patients (mean age 76.9 ± 8.1 years; 70.1% women) receiving GC, 120 (7.6%) experienced SAEs (IR 0.039; 95% CI 0.033–0.047). Vitamin D supplementation was documented in 1186 (75.6%) compared with 382 (24.4%) non-supplemented patients. SAE incidence was similar in supplemented (n = 89; 7.5%; IR 0.038, 95% CI 0.030–0.046) and non-supplemented patients (n = 31; 8.1%; IR 0.045, 95% CI 0.031–0.064) (p = 0.387). Multivariable Cox regression showed a significant interaction between vitamin D supplementation and cumulative glucocorticoid dose (interaction term HR 0.90; p = 0.033), consistent with a dose-dependent protective effect. Conclusions: Vitamin D supplementation was not independently associated with a lower incidence of GC-related SAEs, likely due to residual confounding factors. However, the interaction with cumulative GC exposure suggests a modulatory effect. Prospective studies incorporating stratified baseline vitamin D assessments are warranted.
Source: Nutrients
DOI: 10.3390/nu17203291
Authors: Gastón A. Ghio, Marta Domínguez-Álvaro, Iñigo Hernández Rodríguez, Elisa Fernández-Fernández, Maite Silva-Díaz, Joaquín M. Belzunegui, Clara Moriano, Julio Sánchez Martín, Javier Narváez, Eva Galíndez Agirregoikoa, Anne Riveros Frutos, Francisco Ortiz Sanjuán, Tarek C. Salman Monte, Margarida Vasques Rocha, Carlota L. Iñiguez, Alicia García Dorta, Clara Molina Almela, María Alcalde Villar, José L. Hernández, Santos Castañeda, Ricardo Blanco
Institutions: University Hospital Mútua de Terrassa, Sociedad Española de Reumatología, University Hospital Complex Of Vigo, Hospital Universitario La Paz, Complexo Hospitalario Universitario A Coruña, Donostiako Unibertsitate Ospitalea, Hospital Universitario de León, Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla, Bellvitge University Hospital, Hospital de Basurto, Hospital Universitari Germans Trias i Pujol, Hospital Universitari i Politècnic La Fe, Hospital Del Mar, Hospital Universitario Araba, Hospital Universitario Lucus Augusti, Hospital Universitario de Canarias, Hospital General Universitario De Valencia, Hospital Universitario Severo Ochoa, Universidad de Cantabria, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, Universidad Autónoma de Madrid
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,499
OpenAlex ID: W4415359887