title: Higher 25-hydroxyvitamin D levels are associated with greater odds of remission with anti-tumour necrosis factor-α medications among patients with inflammatory bowel diseases.
abstract: Vitamin D has been linked to disease activity among patients with inflammatory bowel diseases (IBD). Prior investigation has also suggested that vitamin D levels may affect duration of therapy with anti-tumour necrosis factor-α (anti-TNF-α) medications among patients with IBD.
  
  
  
  To evaluate the relationship between vitamin D levels and odds of reaching remission while on an anti-TNF-α medication.
  
  
  
  A total of 521 IBD patients enrolled in the Brigham and Women's IBD Centre database were eligible for inclusion. Patients treated with anti-TNF-α therapy who had vitamin D levels drawn within 6 months prior or 2 weeks after initiation of anti-TNF-α medication and who had reported remission status at 3 months were included. A logistic regression model adjusting for age, gender, IBD diagnosis, anti-TNF-α medication (infliximab vs. adalimumab) and first or subsequent anti-TNF-α medication was used to identify the effect of vitamin D level on initial response to anti-TNF-α therapy.
  
  
  
  A total of 173 patients were included in the final analysis. On logistic regression, patients with normal vitamin D levels n = 122 at the time of anti-TNF-α medication initiation had a 2.64 increased odds of remission at 3 months compared to patients with low vitamin D levels n = 51 when controlling for age, gender, diagnosis, type of anti-TNF-α medication and first or subsequent anti-TNF-α medication (OR = 2.64, 95% CI = 1.31-5.32, P = 0.0067).
  
  
  
  These findings suggest that vitamin D levels may influence initial response to anti-TNF-α medication and that low vitamin D levels may pre-dispose patients to decreased odds of remission.
authors.affiliation: Division of Gastroenterology and Hepatology, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: R W
authors.identifier: 0000-0002-6688-0552
authors.initials: RW
authors.lastname: Winter
authors.affiliation: Division of Gastroenterology and Hepatology, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: E
authors.initials: E
authors.lastname: Collins
authors.affiliation: Division of Gastroenterology and Hepatology, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: B
authors.initials: B
authors.lastname: Cao
authors.affiliation: Division of Gastroenterology and Hepatology, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Carrellas
authors.affiliation: Division of Gastroenterology and Hepatology, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Crowell
authors.affiliation: Division of Gastroenterology and Hepatology, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Korzenik
mesh_terms: D000068879:Adalimumab / Q000008:administration & dosage; D000328:Adult; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D000069285:Infliximab / Q000008:administration & dosage; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D055815:Young Adult
chemical_list: D014409:Tumor Necrosis Factor-alpha; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D000069285:Infliximab; D000068879:Adalimumab