High-dose vitamin D may stop early MS disease activity

A recent Phase 3 clinical trial has revealed that high-dose vitamin D supplementation can significantly reduce disease activity in patients experiencing clinically isolated syndrome (CIS), an initial episode of neurological symptoms indicative of multiple sclerosis (MS). The study, published in JAMA, suggests that vitamin D may serve as a beneficial adjunct therapy in managing MS.​

In MS, the immune system mistakenly attacks the brain and spinal cord, leading to inflammation and damage. CIS represents the first occurrence of such symptoms, with some individuals progressing to MS over time. Given the role of vitamin D in immune modulation, its supplementation has been explored as a potential strategy to mitigate MS disease activity, though previous results have been inconsistent.​

This trial enrolled 303 adults aged 18-55 who had experienced a CIS episode within the past three months and were not on disease-modifying therapy. Participants were randomly assigned to receive either 100,000 International Units of cholecalciferol (vitamin D3) or a placebo, biweekly for up to two years or until MS conversion. Disease activity was monitored through MRI scans and clinical assessments.​

Findings indicated that 60.3% of the vitamin D group experienced disease activity, compared to 74.1% in the placebo group. The average time to new disease activity was significantly longer in the vitamin D group (432 days) versus the placebo group (224 days). Additionally, MRI markers of disease activity were less frequent among those receiving vitamin D. However, no significant differences were observed in relapse rates, disability progression, fatigue, depression, anxiety, or quality of life between the two groups.​

The treatment was generally well-tolerated, with those lacking spinal cord lesions, having severe vitamin D deficiency, and a normal body mass index at baseline deriving the most benefit. Researchers propose that high-dose vitamin D could be a cost-effective therapeutic option, especially in regions with limited access to disease-modifying therapies. They advocate for larger, longer-term studies to further evaluate its efficacy and safety.​