MedicalResearch.com Interview with:
Changhai Ding, MBBS, MMED, MD
Australian Research Council Future Fellow
Associate Director (International), Menzies Institute for Medical Research
Professor, University of Tasmania, Australia
Honorary Professor, University of Sydney, Australia
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Ding: Vitamin D can reduce bone turnover and cartilage degradation, thus potentially preventing the development and progression of knee osteoarthritis. Observational studies suggest that vitamin D supplementation is associated with benefits for knee osteoarthritis, but current evidence from clinical trials is contradictory.
We conducted a randomised clinical trial in Hobart, Tasmania and Melbourne, Victoria in Australia. We randomly assigned 413 patients with symptomatic knee osteoarthritis and low 25-hydroxyvitamin D to receive monthly treatment with oral vitamin D3 (50,000 IU; n = 209) or an identical placebo (n = 204) for 2 years.
Of 413 enrolled participants (average age, 63 years; 50 percent women), 340 (82 percent) completed the study. Vitamin D supplementation significantly increased blood 25-hydroxyvitamin D levels over 2 years compared with placebo treatment; however, vitamin D supplementation, compared with placebo, did not result in significant differences in change in MRI-measured tibial cartilage volume or a measure of knee pain over 2 years. There were also no significant differences in change of tibiofemoral cartilage defects or change in tibiofemoral bone marrow lesions.
Post-hoc analyses indicated that vitamin D supplementation might improve knee physical function and reduce another measure of knee pain and increases in bone marrow lesion.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Ding: These data suggest a lack of evidence to support vitamin D supplementation for slowing knee cartilage loss in knee osteoarthritis.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Ding: Although vitamin D supplementation has no significant effect on knee cartilage loss in knee osteoarthritis, post-hoc analyses suggest it may have a modest effect on bone marrow lesions. Therefore further studies using outcome measures such as bone marrow lesions and joint effusion synovitis are required to test effects of vitamin D supplementation.
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Changhai Ding, M.D., Ph.D et al. Effect of Vitamin D Supplementation on Tibial Cartilage Volume and Knee Pain Among Patients With Symptomatic Knee Osteoarthritis: A Randomized Clinical Trial. JAMA, March 2016 DOI: 10.1001/jama.2016.1961
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Dr. Chang-Hai Ding (2016). Vitamin D Supplements Did Not Slow Knee Cartilage Loss in Osteoarthritis MedicalResearch.com