A Systematic Review and Meta-Analysis of the Effects of Vitamin D on Systemic Lupus Erythematosus
Bibliographic record
Abstract
Background and Objective: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by widespread inflammation and multisystem involvement, leading to substantial morbidity. Given the immunomodulatory role of vitamin D and its association with disease activity in SLE, supplementation has emerged as a potential therapeutic strategy. However, findings across individual studies remain inconsistent, underscoring the need for a systematic review and meta-analysis to synthesize the current evidence on vitamin D supplementation for this disease. Thus, this study aimed to conduct a systematic review and meta-analysis on the effects of vitamin D supplementation on disease activity among patients with SLE. Methods: Systematic searches were carried out in four electronic databases (PubMed, Scopus, Web of Science, and Science Direct) with only studies published after 2013 as a restriction for the search strategy. An assessment of the included studies was conducted according to the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, using the risk of bias assessment tool in Review Manager (Revman) version 5.3. Included studies were randomized trials with vitamin D supplementation in patients with SLE and with pre–post intervention measures of disease activity. Meta-analyses were performed using random-effects models to estimate mean differences with 95% confidence intervals (CIs). Heterogeneity was evaluated using the I2 test, and sensitivity analysis and publication bias assessment were also performed. Results: A total of 186 articles were retrieved, of which 21 studies met the inclusion criteria. These studies had a combined sample size of 3177 adult participants and were conducted across 16 different countries. Regarding the impact of vitamin D supplementation on SLE patients, twelve (n = 12) studies reported positive associations, including reduced disease activity and improvements in clinical and laboratory parameters such as inflammatory markers, fatigue, and bone mineral density. In contrast, nine (n = 9) studies found no significant effects. In terms of meta-analytical data, our results indicate that, at the end of the supplementation, participants with vitamin D supplementation had significantly higher serum vitamin D levels compared to participants that receive a placebo (MD: 13.11 ng/mL; 95% CI: 8 to 19; p < 0.00001) despite comparable values before the onset of the supplementation. In addition, participants with vitamin D supplementation had lower scores in the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) compared to participants who received a placebo (MD: −1; 95% CI: −2 to −0.43; p = 0.002) despite comparable values before the onset of the supplementation. Conclusions: Our systematic review and meta-analysis suggest that vitamin D supplementation leads to a statistically significant reduction in SLEDAI scores, reflecting a meaningful decrease in disease activity. Given its immunomodulatory effects and favorable safety profile, vitamin D supplementation represents a simple and accessible adjunctive strategy that could support SLE management and improve patient outcomes in clinical practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.051 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.023 | 0.040 |
| Bibliometrics | 0.011 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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 source (direct Gemma or distilled Codex), 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".