Vitamin D Deficiency in Systemic Sclerosis Patients: Relations with Multiple Clinical Parameters and Standard Treatment

Amelia Chiara Trombetta¹, Vanessa Smith², Emanuele Gotelli¹, Massimo Ghio¹, Sabrina Paolino¹, Carmen Pizzorni³, Amber Vanhaecke⁴, Barbara Ruaro⁵, Alberto Sulli³ and Maurizio Cutolo³, ¹Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS San Martino, Genoa, Italy, Genoa, Italy, ²Faculty of Internal Medicine, Ghent University, Ghent, Belgium, ³Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy, Genoa, Italy, ⁴Department of Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium, Gent, Belgium, ⁵Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Genoa, Italy, Genoa, Italy

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: complications, systemic sclerosis and treatment, Vitamin D

Session Information

Date: Tuesday, November 7, 2017

Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's – Clinical Aspects and Therapeutics Poster III

Session Type: ACR Poster Session C

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

Vitamin D Deficiency In Systemic Sclerosis Patients:

Relations With Multiple Clinical Parameters and Standard Treatment

Background/Purpose : In SSc patients, low 25-hydroxyvitamin D (25(OH)D) serum concentrations have been shown [1]. Primary aim of the study was to evaluate possible correlations between 25(OH)D serum levels and multiple clinical parameters, in patients with systemic sclerosis (SSc). Secondary aim was the evaluation of the effectiveness of standard vitamin D replacement therapy.

Methods: 154 SSc patients were recruited in all seasons of the year. 25(OH)D serum concentrations were evaluated using LIAISON 25-OH system (Diasorin, Italy). In addition, MedsgerÕs disease severity scale (DSS), nailfold video capillaroscopy (NVC) and all examinations covered by the international guidelines were evaluated [2]. Treatments assumption, including oral colecalciferol, was considered. Non-parametric tests were used for statistical analysis.

Results: 25(OH)D mean serum concentration was 18.7 ±9 ng/ml (<20 classified as a deficiency). A statistically significant correlation was found with presence/absence of fibrotic abnormalities at lung CT scan (16.1 ±8 ng/ml and 20 ±10 ng/ml respectively, p= 0.04) (Figure 1A). DSS parameters correlating with serum concentrations of 25(OH)D were: peripheral vascular (p= 0.03), kidney (p= 0.02), gastrointestinal (p= 0.05) (Figure 1B, 1C, 1D). No significant correlation was observed with digital ulcers incidence, which was closely related to NVC patterns (p<0.0001).

As expected, a statistically significant difference was observed between 25(OH)D serum concentrations in different seasons (winter: 14.6 ±7.8 ng/ml, spring: 17.2 ±7.9 ng/ml, summer: 21.43 ±10 ng/ml, autumn: 20.2 ±10 ng/ml, p= 0.032) (Figure 1E).

No effect of oral colecalciferol (1000 UI per day for at least 6 months) was observed on serum 25(OH)D both in treated (18.8 ±10 ng/ml) or untreated patients (18.7 ±9 ng/ml, p= 0.81) (Figure 1F).

Conclusion: 25(OH)D deficiency correlated with advanced lung involvement and peripheral vascular system, kidney, and gastrointestinal tract involvement (according to the MedsgerÕs DSS). Supplementation with standard doses of oral colecalciferol was not effective in increasing serum concentrations of 25(OH)D. Therefore, for substitutive therapy, higher doses of colecalciferol should be evaluated [3].

References. [1] Cutolo M et al. Nat Rev. Rheumatol 2010; 6: 578-87; [2] Medsger TA Jr et al. J Rheumatol 1999; 26: 2159-67; [3] Tangpricha V et al. J Clin Endocrinol Metab 2012; 97: 1082-93.

Disclosure: A. C. Trombetta, None; V. Smith, None; E. Gotelli, None; M. Ghio, None; S. Paolino, None; C. Pizzorni, None; A. Vanhaecke, None; B. Ruaro, None; A. Sulli, None; M. Cutolo, None.

To cite this abstract in AMA style:

Trombetta AC, Smith V, Gotelli E, Ghio M, Paolino S, Pizzorni C, Vanhaecke A, Ruaro B, Sulli A, Cutolo M. Vitamin D Deficiency in Systemic Sclerosis Patients: Relations with Multiple Clinical Parameters and Standard Treatment [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/vitamin-d-deficiency-in-systemic-sclerosis-patients-relations-with-multiple-clinical-parameters-and-standard-treatment/. Accessed .

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