HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Read responses to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wingerchuk, D M Articles by Ebers, G C Search for Related Content PubMed PubMed Citation Articles by Wingerchuk, D M Articles by Ebers, G C

A pilot study of oral calcitriol (1,25-dihydroxyvitamin D₃) for relapsing–remitting multiple sclerosis

¹ Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA
² Department of Clinical Neurological Sciences, University of Western Ontario, London, Canada
³ Department of Clinical Neurology, University of Oxford, Oxford, UK

Correspondence to:
Correspondence to:
Dr Dean M Wingerchuk
Mayo Clinic, Scottsdale, Arizona, USA; wingerchuk.dean{at}mayo.edu

ABSTRACT
Background: Epidemiological and ecological studies suggest links between vitamin D deficiency and increased multiple sclerosis (MS) prevalence.

Objective: To evaluate the safety and tolerability of oral calcitriol therapy in an open label pilot study.

Methods: 15 ambulatory patients with relapsing–remitting MS and at least one clinical relapse within the previous 12 months received oral calcitriol (target dose: 2.5 µg/d) for 48 weeks. Dietary calcium was restricted to 800 mg/d. Patients were monitored using frequent clinical and laboratory examinations, the expanded disability status scale (EDSS), and brain magnetic resonance imaging (MRI).

Results: Two patients withdrew because of symptomatic hypercalcaemia (serum calcium >3.35 mmol/l in each case) resulting from persistent dietary indiscretion. Two diet compliant patients required temporary dose adjustments for mild asymptomatic hypercalcaemia. Diet compliant patients experienced mild adverse effects. The on-study exacerbation rate (27%) was less than baseline. Four patients experienced five clinical relapses but only one patient worsened by >1 EDSS point. Brain MRI revealed enhancing lesions in five patients at baseline (33%) and in four (29%) at both 24 and 48 weeks.

Conclusions: Oral calcitriol is safe and well tolerated for up to one year by diet compliant relapsing–remitting MS patients. Further study of vitamin D related mechanisms is warranted in MS.

Abbreviations: EDSS, expanded disability status scale; MS, multiple sclerosis

Keywords: multiple sclerosis; calcitriol; clinical trial

This article has been cited by other articles:

				M Soilu-Hanninen, M Laaksonen, I Laitinen, J-P Eralinna, E-M Lilius, and I Mononen A longitudinal study of serum 25-hydroxyvitamin D and intact parathyroid hormone levels indicate the importance of vitamin D and calcium homeostasis regulation in multiple sclerosis J. Neurol. Neurosurg. Psychiatry, February 1, 2008; 79(2): 152 - 157. [Abstract] [Full Text] [PDF]

				S. M Kimball, M. R Ursell, P. O'Connor, and R. Vieth Safety of vitamin D3 in adults with multiple sclerosis Am. J. Clinical Nutrition, September 1, 2007; 86(3): 645 - 651. [Abstract] [Full Text] [PDF]

				S. J Brown The Role of Vitamin D in Multiple Sclerosis Ann. Pharmacother., June 1, 2006; 40(6): 1158 - 1161. [Abstract] [Full Text] [PDF]

eLetters: