Vitamin D supplementation to palliative cancer patients shows positive effects on pain and infections-Results from a matched case-control study.
We previously showed an association between low vitamin D levels and high opioid doses to alleviate pain in palliative cancer patients. The aim of this case-controlled study was to investigate if vitamin D supplementation could improve pain management, quality of life (QoL) and decrease infections i...
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doaj-81142550dfda4633960894874017e62f2020-11-25T02:47:45ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01128e018420810.1371/journal.pone.0184208Vitamin D supplementation to palliative cancer patients shows positive effects on pain and infections-Results from a matched case-control study.Maria Helde-FranklingJonas HöijerJenny BergqvistLinda Björkhem-BergmanWe previously showed an association between low vitamin D levels and high opioid doses to alleviate pain in palliative cancer patients. The aim of this case-controlled study was to investigate if vitamin D supplementation could improve pain management, quality of life (QoL) and decrease infections in palliative cancer patients.Thirty-nine palliative cancer patients with levels of 25-hydroxyvitamin D < 75 nmol/L were supplemented with vitamin D 4000 IE/day, and were compared to 39 untreated, matched "control"-patients from a previous study at the same ward. Opioid doses, antibiotic consumption and QoL-scores measured with the Edmonton Symptom Assessment Scale (ESAS) were monitored. The primary endpoint was the change from baseline after 1 and 3 months compared between the groups using linear regression with adjustment for a potential cofounding factor.After 1 month the vitamin D treated group had a significantly decreased fentanyl dose compared to the untreated group with a difference of 46 μg/h; 95% CI 24-78, which increased further at 3 months to 91 μg/h; 95% CI 56-140 μg/h. The ESAS QoL-score improved in the Vitamin D group the first month; -1.4; 95% CI -2.6 - (-0.21). The vitamin D-treated group had significantly lower consumption of antibiotics after 3 months compared to the untreated group, the difference was -26%; 95%CI -0.41%-(-0.12%). Vitamin D was well tolerated by all patients and no adverse events were reported.Vitamin D supplementation to palliative cancer patients is safe and improvement in pain management is noted as early as 1 month after treatment. Decreased infections are noted 3 months after vitamin D treatment. The results from this pilot-study have been used for the power-calculation of a future randomized, placebo-controlled, double-blind study called "Palliative-D" that will start in Nov 2017 and will include 254 palliative cancer patients.http://europepmc.org/articles/PMC5578640?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Maria Helde-Frankling Jonas Höijer Jenny Bergqvist Linda Björkhem-Bergman |
spellingShingle |
Maria Helde-Frankling Jonas Höijer Jenny Bergqvist Linda Björkhem-Bergman Vitamin D supplementation to palliative cancer patients shows positive effects on pain and infections-Results from a matched case-control study. PLoS ONE |
author_facet |
Maria Helde-Frankling Jonas Höijer Jenny Bergqvist Linda Björkhem-Bergman |
author_sort |
Maria Helde-Frankling |
title |
Vitamin D supplementation to palliative cancer patients shows positive effects on pain and infections-Results from a matched case-control study. |
title_short |
Vitamin D supplementation to palliative cancer patients shows positive effects on pain and infections-Results from a matched case-control study. |
title_full |
Vitamin D supplementation to palliative cancer patients shows positive effects on pain and infections-Results from a matched case-control study. |
title_fullStr |
Vitamin D supplementation to palliative cancer patients shows positive effects on pain and infections-Results from a matched case-control study. |
title_full_unstemmed |
Vitamin D supplementation to palliative cancer patients shows positive effects on pain and infections-Results from a matched case-control study. |
title_sort |
vitamin d supplementation to palliative cancer patients shows positive effects on pain and infections-results from a matched case-control study. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2017-01-01 |
description |
We previously showed an association between low vitamin D levels and high opioid doses to alleviate pain in palliative cancer patients. The aim of this case-controlled study was to investigate if vitamin D supplementation could improve pain management, quality of life (QoL) and decrease infections in palliative cancer patients.Thirty-nine palliative cancer patients with levels of 25-hydroxyvitamin D < 75 nmol/L were supplemented with vitamin D 4000 IE/day, and were compared to 39 untreated, matched "control"-patients from a previous study at the same ward. Opioid doses, antibiotic consumption and QoL-scores measured with the Edmonton Symptom Assessment Scale (ESAS) were monitored. The primary endpoint was the change from baseline after 1 and 3 months compared between the groups using linear regression with adjustment for a potential cofounding factor.After 1 month the vitamin D treated group had a significantly decreased fentanyl dose compared to the untreated group with a difference of 46 μg/h; 95% CI 24-78, which increased further at 3 months to 91 μg/h; 95% CI 56-140 μg/h. The ESAS QoL-score improved in the Vitamin D group the first month; -1.4; 95% CI -2.6 - (-0.21). The vitamin D-treated group had significantly lower consumption of antibiotics after 3 months compared to the untreated group, the difference was -26%; 95%CI -0.41%-(-0.12%). Vitamin D was well tolerated by all patients and no adverse events were reported.Vitamin D supplementation to palliative cancer patients is safe and improvement in pain management is noted as early as 1 month after treatment. Decreased infections are noted 3 months after vitamin D treatment. The results from this pilot-study have been used for the power-calculation of a future randomized, placebo-controlled, double-blind study called "Palliative-D" that will start in Nov 2017 and will include 254 palliative cancer patients. |
url |
http://europepmc.org/articles/PMC5578640?pdf=render |
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