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Daily v. weekly oral vitamin D3 therapy for nutritional rickets in Indian children: a randomised controlled open-label trial

Published online by Cambridge University Press:  13 May 2022

Aashima Dabas Open the ORCID record for Aashima Dabas [Opens in a new window] ,
Vineet Dabas ,
Pradeep Kumar Dabla ,
Raman Kumar Marwaha Open the ORCID record for Raman Kumar Marwaha [Opens in a new window] ,
Sangeeta Yadav ,
Madhavi Bharadwaj ,
Vernika Tyagi  and
Shipra Agrawal
Aashima Dabas*
Affiliation:
Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
Vineet Dabas
Affiliation:
Department of Orthopedics, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
Pradeep Kumar Dabla
Affiliation:
Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
Raman Kumar Marwaha
Affiliation:
Consultant Endocrinologist and President, Society for Endocrine Health of Elderly, Adolescents and Children, New Delhi, India
Sangeeta Yadav
Affiliation:
Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
Madhavi Bharadwaj
Affiliation:
Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
Vernika Tyagi
Affiliation:
Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
Shipra Agrawal
Affiliation:
Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
*
* Corresponding author: Aashima Dabas, email dr.aashimagupta@gmail.com
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Abstract

The aim of the study was to compare the efficacy of daily v. weekly oral vitamin D3 therapy in radiological healing of nutritional rickets. Children 6 months to 12 years (n 132) diagnosed with nutritional rickets were randomised into three groups (n 44): group A – 2000 IU daily vitamin D3 for 12 weeks, B – 60 000 IU weekly for 3 weeks, C – 60 000 IU weekly for 6 weeks. Serum calcium, phosphorus, 25-hydroxyvitamin D (25(OH)D), parathyroid hormone and X-ray score were estimated at baseline and 12 weeks (endline). The proportion of children who achieved complete radiological healing at endline was compared between three groups by χ2 and delta change in laboratory parameters by ANOVA (parametric data) or Kruskal Wallis test (non-parametric data), respectively. Baseline 25(OH)D ≤ 20 ng/ml was seen in 119 (90·2 %), hyperparathyroidism in 90 (68·8 %) and hypocalcaemia in 96 (72·7 %). A total of 120/132 children completed the study. Complete radiological healing seen in 30 (75 %) in group A, 23 (60·5 %) in group B and 26 (61·9 %) in group C; P = 0·15, with comparable endline X-ray scores; P = 0·31. The median (interquartile range (IQR)) delta X-ray score (baseline–endline) was 7 (4,9), 5 (2·25, 6) and 6 (4,7) in groups A, B and C, respectively; P = 0·019. Median (IQR) 25(OH)D endline levels in groups A, B and C were 50·0 (26·5, 66·5), 42·1 (28·4, 54·4) and 53·5 (33·7, 71·2) ng/ml, respectively; P = 0·045. Radiological scores were comparable at endline among daily and weekly vitamin D groups with greater change from baseline in daily supplemented group.

Keywords

CholecalciferolStoss therapyVitamin D deficiencyHypocalcaemia25-hydroxyvitamin D
Type
Research Article
Information
British Journal of Nutrition , Volume 129 , Issue 9 , 14 May 2023 , pp. 1473 - 1480
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Nutrition Society

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