Differences in outcomes between cholecalciferol and ergocalciferol supplementation in veterans with inflammatory bowel disease.
OBJECTIVE
Vitamin D deficiency is a global health issue associated with increased health-care costs, and could play a role in the pathogenesis and management of inflammatory bowel disease. Prior studies show a high prevalence of vitamin D deficiency in veterans with inflammatory bowel disease. We aimed to examine the outcome differences in patients with inflammatory bowel disease, comparing treatment with ergocalciferol to cholecalciferol.


METHODS
A retrospective review of electronic medical records of patients with inflammatory bowel disease at a Veterans Affairs Medical Facility in the Southeastern United States was carried out. Those with at least one serum 25(OH) vitamin D level were included. Initial and follow-up vitamin D values were recorded. The type of vitamin D supplementation, whether cholecalciferol or ergocalciferol, was documented. Costs in the year after measurement of vitamin D were divided into separate inpatient and outpatient categories.


RESULTS
Veterans (n = 108) with ulcerative colitis or Crohn's disease and an available 25(OH) vitamin D level were studied. There were differences in follow-up vitamin D levels; those who received weekly ergocalciferol had higher subsequent levels than those who received cholecalciferol, especially at a second follow up, although differences did not achieve statistical significance. However, those who received vitamin D3 were less likely to use laboratory, pharmacy, radiology and fee-based services, and had lower laboratory and pharmacy costs.


CONCLUSIONS
Our data suggest that cholecalciferol replacement might improve outcomes to a greater extent than ergocalciferol, and might be better in limiting health-care costs and expenses in patients with inflammatory bowel disease.
Department of Internal Medicine, Division of Infectious Diseases, East Tennessee State University, Johnson City, Tennessee, USA.
Dima
D
Youssef
Beth
B
Bailey
Antwan
A
Atia
Adel
A
El-Abbassi
Todd
T
Manning
Alan N
AN
Peiris
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002762:Cholecalciferol / Q000172:deficiency / Q000627:therapeutic use*; D004872:Ergocalciferols / Q000172:deficiency / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015144:Southeastern United States / Q000453:epidemiology; D016896:Treatment Outcome; D014728:Veterans; D014808:Vitamin D Deficiency / Q000188:drug therapy* / Q000453:epidemiology
D004872:Ergocalciferols; D002762:Cholecalciferol