Personalized choice of dosage regimens and duration of vitamin D use in juvenile idiopathic arthritis
Authors:   SI Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine, Kyiv, Mukvich O.M. , Vdovina N.M. ,   SI Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine, Kyiv, Omelchenko L.I. ,   SI Institute of Pediatrics of Obstetrics and Gynecology named after academician O.М. Lukyanova of the NAMS of Ukraine, Kyiv, Ludvik T.A. ,   SI Institute of Pediatrics of Obstetrics and Gynecology named after academician O.М. Lukyanova of the NAMS of Ukraine, Kyiv, Strizhak S.K. ,   SI Institute of Pediatrics of Obstetrics and Gynecology named after academician O.М. Lukyanova of the NAMS of Ukraine, Kyiv
Published: November 2022

Purpose - to increase the effectiveness of prevention and correction of D hypovitaminosis in juvenile idiopathic arthritis (JIA) by optimizing the algorithms of dosage regimens and duration of vitamin D supplementation. Materials and methods. A clinical and laboratory examination of 118 children aged 3 to 18 years with a diagnosis of JIA was carried out. Vitamin D status was assessed by the concentration of 25(OH)D in the blood serum using a Reader ER 500 enzyme immunoassay photoelectric analyzer. All patients in the complex of therapeutic measures were prescribed vitamin D3 preparations according to the developed algorithms, taking into account the presence of trigger factors for reducing the supply of this vitamin to the body, existing world recommendations and the initial level of 25(OH)D in blood serum. Results. The use of vitamin D3 preparations according to the scheme of 4000 IU/d for two months, followed by continuation at a dose of 2000 IU/d for one month, contributed to the achievement of sufficient concentrations of 25(ОH)D (36.7-47.5 ng/ml) in the blood serum in all patients. When taking vitamin D at a dose of 4000 IU/d for one month, and then for another two months at 2000 IU/d, the optimal concentrations of 25(OH)D in the blood serum (31.55-45.14 ng/ml) were achieved only in 52.9% children. Maintenance therapy in the future for 6 months at a dose of 1000 IU/d provided sufficient concentrations of vitamin D in 61.86% of children, and in 38.14% there was a tendency to reduce the content of 25(OH)D (26.83±2.99) ng/ml, which indicated the insufficiency of the specified maintenance dose of vitamin D for children with chronic progressive inflammation and the presence of comorbid pathology and the impact on adverse risk factors that affect the body’s supply of this vitamin. Conclusions. In JIA, the dose of saturation (4000-6000 IU/d) with vitamin D preparations should be determined depending on the initial degree of its insufficiency in the body, the characteristics of the clinical course and treatment of the underlying disease, and the presence of factors that contribute to a decrease in the supply of vitamin D to the body. Maintenance therapy at a dose of 2000 IU/d for 6 months makes it possible to maintain the optimal concentration of 25(OH)D in the body with a high probability. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.