Impact of vitamin D supplementation on anti-TNFα therapy in Crohn's disease: systematic review and meta-analysis
Bibliographic record
Abstract
INTRODUCTION: Although antitumor necrosis factor alpha (anti-TNFα) has revolutionized the treatment of Crohn’s disease (CD), significant loss of response may occur over-time. Vitamin D (VD) is a polyvalent nutrient shown to regulate the microbiome, intestinal barrier and inflammatory cytokines, including TNFα. As CD patients have a higher risk of VD deficiency, we aimed to analyze the impact of VD on the clinical efficacy of anti-TNFα therapy in CD.EVIDENCE ACQUISITION: Systematic review and metanalysis conducted in accordance with PRISMA protocol. Major databases were searched for clinical trials and prospective studies using VD supplementation to augment anti-TNFα therapy in moderate to severe CD. Metanalysis was performed using random-effects model.EVIDENCE SYNTHESIS: From a total of 2021 articles, four were included. Two clinicals trials (Brazil and Denmark) and two prospective interventionist studies (Denmark and Canada), performed from 2016 to 2021. No benefit of VD supplementation was found on clinical and laboratory response to induction using anti-TNFα therapy until week 14th. Regarding maintenance therapy with anti-TNFα, metanalysis including 91 patients from the identified studies showed a positive trend towards VD supplementation on clinical outcomes (OR 1.88 [CI 95% 0.04-78.9]) between 22 to 52 weeks.CONCLUSIONS: Our study demonstrated a non-statistically significant, but positive trend in clinical response following VD supplementation in the first year of anti-TNFα therapy. As VD deficiency is common in this population, further well-powered prospective studies are needed to better define the impact of VD in outcomes of CD patients using anti-TNFα.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".