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Vitamin D Oral Replacement in Children With Obesity Related Asthma: VDORA1 Randomized Clinical Trial.

Clinical pharmacology and therapeutics
February 1, 2024
Brian O'Sullivan et al. (24 authors)
Randomized Controlled TrialJournal ArticleResearch Support, N.I.H., ExtramuralHuman StudyClinical
Study Details

Study Goal

The researchers aimed to identify a safe and effective vitamin D dose for children with obesity-related asthma to achieve serum vitamin D levels ≥ 40 ng/mL.

Results Summary

The study found that a 50,000 IU loading dose plus 8,000 IU daily oral vitamin D safely and effectively increased serum 25(OH)D levels to ≥ 40 ng/mL in 78.6% of participants, compared to none in the standard-of-care group. No serious adverse events were reported.

Population

Children/adolescents with asthma and a body mass index ≥ 85% for age/sex.

Effective Dosage

50,000 IU loading dose followed by 8,000 IU daily.

Duration

16 weeks.

Interactions

None mentioned.

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
oral vitamin D regimens
increase
serum vitamin D levels
children/adolescents with asthma and body mass index ≥ 85% for age/sex
≥ 40 ng/mL
achieved
#1
standard of care (SOC)
no change
target serum level
participants in Part 1
0%
no participants achieved
#2
vitamin D regimens in cohorts A-C
increase
target serum level
participants in Part 1
50-72.7%
achieved
#3
replacement dose (50,000 IU loading dose with 8,000 IU daily)
increase
target serum level
participants in Part 2
78.6%
achieved
#4
standard of care (SOC)
no change
target serum level
participants in Part 2
0%
none achieved
#5
50,000 IU loading dose plus 8,000 IU daily oral vitamin D
increase
serum 25(OH)D levels
children/adolescents with overweight/obesity
≥ 40 ng/mL
safe and effective in increasing
#6
Abstract

Children with asthma and obesity are more likely to have lower vitamin D levels, but the optimal replacement dose is unknown in this population. The objective of this study is identifying a vitamin D dose in children with obesity-related asthma that safely achieves serum vitamin D levels of ≥ 40 ng/mL. This prospective multisite randomized controlled trial recruited children/adolescents with asthma and body mass index ≥ 85% for age/sex. Part 1 (dose finding), evaluated 4 oral vitamin D regimens for 16 weeks to identify a replacement dose that achieved serum vitamin D levels ≥ 40 ng/mL. Part 2 compared the replacement dose calculated from part 1 (50,000 IU loading dose with 8,000 IU daily) to standard of care (SOC) for 16 weeks to identify the proportion of children achieving target serum 25(OH)D level. Part 1 included 48 randomized participants. Part 2 included 64 participants. In Part 1, no SOC participants achieved target serum level, but 50-72.7% of participants in cohorts A-C achieved the target serum level. In part 2, 78.6% of replacement dose participants achieved target serum level compared with none in the SOC arm. No related serious adverse events were reported. This trial confirmed a 50,000 IU loading dose plus 8,000 IU daily oral vitamin D as safe and effective in increasing serum 25(OH)D levels in children/adolescents with overweight/obesity to levels ≥ 40 ng/mL. Given the critical role of vitamin D in many conditions complicating childhood obesity, these data close a critical gap in our understanding of vitamin D dosing in children.

Medical Subject Headings (MeSH)
AdolescentChildHumansVitamin DCholecalciferolProspective StudiesVitamin D DeficiencyPediatric ObesityVitaminsAsthmaDietary Supplements
Study Links
Quality Scores
Safety90
Efficacy85/10
Quality80/10
Citation Metrics
Total Citations3
Citations/Year3.0
Research Impact Scores
APT Score0.50
Weight Score2.77
Normalized Score0.86
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