dc.contributor.author | Jolliffe, DA | |
dc.contributor.author | Greenberg, L | |
dc.contributor.author | Hooper, RL | |
dc.contributor.author | Mathyssen, C | |
dc.contributor.author | Rafiq, R | |
dc.contributor.author | de Jongh, RT | |
dc.contributor.author | Camargo, CA | |
dc.contributor.author | Griffiths, CJ | |
dc.contributor.author | Janssens, W | |
dc.contributor.author | Martineau, AR | |
dc.date.accessioned | 2019-03-25T14:53:07Z | |
dc.date.available | 2018-11-26 | |
dc.date.available | 2019-03-25T14:53:07Z | |
dc.date.issued | 2019-01-10 | |
dc.date.submitted | 2018-12-06T13:11:14.158Z | |
dc.identifier.citation | Jolliffe DA, Greenberg L, Hooper RL, et al Vitamin D to prevent exacerbations of COPD: systematic review and meta-analysis of individual participant data from randomised controlled trials Thorax 2019;74:337-345. | en_US |
dc.identifier.issn | 1468-3296 | |
dc.identifier.uri | https://qmro.qmul.ac.uk/xmlui/handle/123456789/56466 | |
dc.description.abstract | BACKGROUND: Randomised controlled trials (RCTs) of vitamin D to prevent COPD exacerbations have yielded conflicting results.Individual participant data meta-analysis could identify factors that explain this variation. METHODS: PubMed, Embase, the Cochrane Central Register of Controlled Trials and Web of Science were searched from inception up to and including 5 October 2017 to identify RCTs of vitamin D supplementation in patients with COPD that reported incidence of acute exacerbations. Individual participant data meta-analysis was performed using fixed effects models adjusting for age, sex, Global Initiative for Chronic Obstructive Lung Disease spirometric grade and trial. RESULTS: Four eligible RCTs (total 560 participants) were identified; individual participant data were obtained for 469/472 (99.4%) participants in three RCTs. Supplementation did not influence overall rate of moderate/severe COPD exacerbations (adjusted incidence rate ratio (aIRR) 0.94, 95% CI 0.78 to 1.13). Prespecified subgroup analysis revealed that protective effects were seen in participants with baseline 25-hydroxyvitamin D levels <25 nmol/L (aIRR 0.55, 95% CI 0.36 to 0.84) but not in those with baseline 25-hydroxyvitamin D levels ≥25 nmol/L (aIRR 1.04, 95% CI 0.85 to 1.27; p for interaction=0.015). Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event (adjusted OR 1.16, 95% CI 0.76 to 1.75). CONCLUSIONS: Vitamin D supplementation safely and substantially reduced the rate of moderate/severe COPD exacerbations in patients with baseline 25-hydroxyvitamin D levels <25 nmol/L but not in those with higher levels. TRIAL REGISTRATION NUMBER: CRD42014013953. | en_US |
dc.language | eng | |
dc.language.iso | en | en_US |
dc.publisher | BMJ | en_US |
dc.relation.ispartof | Thorax | |
dc.rights | “This article has been accepted for publication in Thorax, 2019, following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/thoraxjnl-2018-212092” | |
dc.subject | copd exacerbations | en_US |
dc.title | Vitamin D to prevent exacerbations of COPD: systematic review and meta-analysis of individual participant data from randomised controlled trials. | en_US |
dc.type | Article | en_US |
dc.identifier.doi | 10.1136/thoraxjnl-2018-212092 | |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/30630893 | en_US |
pubs.issue | 4 | |
pubs.notes | Not known | en_US |
pubs.notes | Not yet published | en_US |
pubs.publication-status | Published online | en_US |
pubs.volume | 74 | |
dcterms.dateAccepted | 2018-11-26 | |
rioxxterms.funder | Default funder | en_US |
rioxxterms.identifier.project | Default project | en_US |