In the pipeline
for MS: Vitamin D
supplementation
•;A;new;clinical;trial;is
studying whether vitamin D
added to standard therapy
with Copaxone reduces the
frequency of MS relapses.
COuRTeSy OF The MINNeSOTA ChAPTeR
Why use vitamin D to
treat MS?
Research on vitamin D began
with a simple observation: that
MS occurs less often in regions
of the world where exposure to
sunlight—which contributes to
the body’s production of vitamin
D—is high. Could it be that
exposure to sunlight or levels
of vitamin D in the blood are
important environmental factors
that combine with genetics to
determine MS risk or severity?
Subsequent studies in lab mice
showed that vitamin D can
reduce the effects of EAE, an
MS-like disease; epidemiologic
studies (studies of who gets MS)
have backed them up, clearly
linking decreased vitamin D
levels to increased MS risk or
severity. This growing evidence
suggests it is time to test
whether vitamin D supplements
can provide benefits to people
who have MS.
What does the research
show so far?
In a small safety study, Paul
O’Connor, MD, and Jodie
Burton, MD (St. Michael’s
Hospital, Toronto) and their
colleagues examined the effects
of administering increasing
doses of vitamin D3. A
group of 25 people with MS
were given 4,000 to 40,000
international units (IU) per
day for a year, while 24 people
with MS in a control group
were limited to 600 IU, the
maximum amount the Institute
of Medicine recommends to
avoid adverse effects, such as
excessive blood calcium levels.
Calcium levels remained within
normal limits in this small study,
demonstrating that people with
MS can tolerate higher levels of
the vitamin. The relapse rate was
reduced more in the treatment
group, but this finding did not
reach statistical significance
(Neurology 2010;74:1852).
In the same study, the team
also found that immune T
cells involved in MS attacks
were calmed in those who
achieved high blood levels of
vitamin D (The Journal of
Clinical Endocrinology and
Metabolism 2011;96:2826).
What is being tested in a new
clinical trial?
Ellen Mowry, MD, MCR
(Johns Hopkins University)
is funded by the Society
to conduct a controlled
clinical trial to determine
whether high-dose vitamin
D added to standard therapy
with Copaxone reduces the
frequency of relapses in people
with MS. In this trial, 172
people who have MS will start
daily Copaxone and will then
be randomly assigned to take
either 600 IU or 5,000 IU
of vitamin D daily. During
the two years of the study,
information about relapse
frequency, disability, MRI scans
and other measures of MS
activity will be collected from
each group.
This study will provide
important evidence to
show whether vitamin D
supplements are a safe and
effective addition to standard
MS therapies. Read more about
this study at
clinicaltrials.gov/
ct2/show/NCT01490502.
