PHILADELPHIA — Patients with moderately active rheumatoid arthritis had a high prevalence of vitamin D insufficiency and deficiency in a prospective study of 1,160 patients in the Veterans Health Administration system.
Based on this finding, the “testing of vitamin D levels is mandatory” in patients with RA, Dr. Gail S. Kerr said at the annual meeting of the American College of Rheumatology.
In addition, although “more evidence is needed to determine the exact role of vitamin D in patients with rheumatoid arthritis, we advocate vitamin D replacement as an additional, non-DMARD component of RA management,” said Dr. Kerr, chief of rheumatology at the Washington D.C. VA Medical Center.
The study used patients who were enrolled in the U.S. VARA (Veterans With RA) registry, which began in 2002. The registry protocol included drawing a blood specimen from patients at the time of enrollment. Patients entered the registry at similar rates throughout the year, which meant that no seasonal bias skewed their vitamin D levels.
The current analysis focused on the 1,160 enrolled patients for whom vitamin D levels were available. Patients' average age was 64 years; 91% were men, 77% were white, and 17% were black. Average duration of RA was 12 years. Insufficiency was defined as a level of 30 ng/mL or lower; deficiency was 20 ng/mL or lower.
Low vitamin D levels were common, with 85% of the patients meeting the definition of insufficiency, and 45% with a deficient level. The average vitamin D level for the entire group was 22 ng/mL.