Vitamin D supplementation fails for fracture prevention | Latest news for doctors, nurses and pharmacists

Supplemental vitamin D intake3 fails to reduce the incidence of fractures in generally healthy middle-aged and elderly adults compared to placebo, according to data from the Vitamin D and Omega-3 (VITAL) trial.

VITAL was a factorial, randomized, two-by-two controlled trial that investigated whether vitamin D supplementation3 (2,000 IU/day), n−3 fatty acids (1 g/day), or both, may prevent cancer and cardiovascular disease in elderly men
50s and older women 55 years in the United States.

This analysis included 25,871 participants (50.6% female, 20.2% black). Recruitment was not based on vitamin D deficiency, low bone mass, or osteoporosis. All participants completed annual questionnaires detailing incident fractures.

Over a median follow-up of 5.3 years, a total of 1,991 incident fractures in 1,551 participants were recorded. The total number of fractures occurred in 769 of 12,927 participants in the vitamin D group and in 782 of 12,944 participants in the placebo group.

Multivariate Cox proportional hazards models confirmed that vitamin D supplementation3 did not have a significant effect on the risk of total fractures compared to placebo (relative risk [HR]0.98, 95% confidence interval [CI], 0.89–1.08; p=0.70). The same was true for non-vertebral fractures (HR, 0.97, 95% CI, 0.87-1.07; p=0.50) and hip fractures (HR, 1.01, CI at 95%, 0.70-1.47; p=0.96).

No modification of treatment effect was detected, with results consistent across subgroups defined by baseline characteristics including age, sex, race or ethnicity, body mass index body or serum levels of 25-hydroxyvitamin D.

In terms of safety, the incidence of adverse events was similar in both groups, as was the case in the parent trial.

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