Effect of Vitamin D on Effusion-Synovitis in Knee Osteoarthritis: a Randomized Controlled Trial

Xia Wang¹, Flavia Cicutinni², Xingzhong Jin¹, Benny Samuel Eathakkattu Antony³, Anita Wluka^2,4,5, Weiyu Han¹, Leigh Blizzard⁶, Tania Winzenberg⁷, Graeme Jones⁸ and Changhai Ding⁸, ¹Menzies institute for medical research, University of Tasmania, Hobart, Australia, ²Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia, ³Musculoskeletal, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia, ⁴Epidemiology & Preventive Med, Monash University, Melbourne, Australia, ⁵Department of Epidemiology and Preventive Medicine, Monash University, Armadale, Australia, ⁶Statistics, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia, ⁷Menzies Institute for Medical Research, University of Tasmania, Hobart,7000, Australia, ⁸Musculoskeletal Unit, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Inflammation, osteoarthritis and synovial fluid, Vitamin D

Session Information

Date: Sunday, November 8, 2015

Title: Osteoarthritis - Clinical Aspects Poster I: Treatments and Metabolic Risk Factors

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: To examine the effect of vitamin D supplementation on synovial inflammation in patients with knee osteoarthritis (OA) and low vitamin D levels over 24 months.

Methods: In a multi-center, parallel, randomized, placebo-controlled and double-blind trial, symptomatic knee OA patients with a low 25-(OH)D level (12.5 to 60 nmol/l) were recruited. 413 patients (age 63.2±7.0 years, 208 females) were allocated monthly to a 50,000IU vitamin D₃ capsule (n=209) or placebo (n=204) for 24 months. In this post-hoc analysis, the primary outcome was change in total knee effusion-synovitis volume assessed using magnetic resonance imaging (MRI). Secondary outcomes included change in regional effusion-synovitis volume, change in semi-quantitative effusion-synovitis score and dichotomized minimal clinical important improvement in effusion-synovitis volume. Generalized linear regression models were used to compare differences between groups in both intention-to-treat and per protocol analyzes.

Results: Serum 25-(OH)D level increased markedly in the vitamin D group (40.6 nmol/l) compared with placebo (6.7 nmol/l) over 24 months. Overall total effusion-synovitis volume significantly increased in all patients (baseline: 8.0 ± 8.5 ml, follow-up: 9.0 ± 10.5 ml), but the increase was less in the vitamin D group than controls (0.26 ml (16% p.a.) versus 2.20 ml (60% p.a.), p = 0.02). This effect was evident in suprapatellar pouch (0.04 ml (19% p.a.) versus 2.53 ml (148% p.a.), p = 0.03), but not in central region (0.12 ml (10% p.a.) versus 0.40 ml (39% p.a.), p = 0.12). The likelihood of achieving a minimal clinical important improvement in total (relative risk: 1.22 p.a.; p = 0.05) and suprapatellar (relative risk: 1.27 p.a.; p = 0.03) effusion-synovitis were significantly higher in vitamin D group compared to placebo. Additionally, change in 25-(OH)D levels was negatively associated with change in total effusion-synovitis volume in whole sample (p = 0.09). Adverse events were similar.

Conclusion: Supplementation of vitamin D in knee OA patients over 24 months can reduce the worsening of knee joint effusion-synovitis, especially in suprapatellar pouch.

Disclosure: X. Wang, None; F. Cicutinni, None; X. Jin, None; B. S. Eathakkattu Antony, None; A. Wluka, None; W. Han, None; L. Blizzard, None; T. Winzenberg, None; G. Jones, None; C. Ding, None.

To cite this abstract in AMA style:

Wang X, Cicutinni F, Jin X, Eathakkattu Antony BS, Wluka A, Han W, Blizzard L, Winzenberg T, Jones G, Ding C. Effect of Vitamin D on Effusion-Synovitis in Knee Osteoarthritis: a Randomized Controlled Trial [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/effect-of-vitamin-d-on-effusion-synovitis-in-knee-osteoarthritis-a-randomized-controlled-trial/. Accessed .

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