title: Effect of alfacalcidol on the pulmonary function of adult asthmatic patients: A randomized trial.
abstract: Despite the use of alfacalcidol in the management of corticosteroid-induced osteoporosis, it has never been considered an adjunct treatment for asthma management. It can target vitamin D deficiency, a possible risk factor for asthma, and, hence, improve pulmonary function of patients with asthma.
  
  
  
  To explore the effect of alfacalcidol administration on pulmonary function and study the pattern of vitamin D deficiency in adults with asthma in Egypt.
  
  
  
  Serum 25-hydroxyvitamin D was measured in 115 adults: 33 healthy subjects and 82 patients with asthma. Then, patients with asthma were randomized to receive standard asthma treatment only (n = 39) or receive it in addition to 1 μg of alfacalcidol daily for 4 months (n = 43). Randomization was stratified by the stage of asthma severity. Spirometry and measurement of 25-hydroxyvitamin were performed at baseline and end of follow-up.
  
  
  
  Vitamin D deficiency was more common in patients with asthma (57.3%) than in healthy subjects (21.2%; P < .001). In patients with asthma, alfacalcidol significantly improved forced expiratory volume in the first second and forced vital capacity (P < .001 for the 2 tests). Moreover, more patients in the intervention arm showed improvement in asthma severity stage (P = .04). A nonsignificant difference was observed in improvement of forced expiratory volume in the first second between patients with vitamin D deficiency and those without deficiency in the intervention group (P > .05).
  
  
  
  Alfacalcidol supplementation improved the pulmonary function and severity stage of adult patients with asthma regardless of deficiency.
  
  
  
  ClinicalTrials.gov Identifier: NCT02747381.
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt. Electronic address: amany.mohamed@pharma.cu.edu.eg.
authors.forename: Amani M
authors.initials: AM
authors.lastname: Ali
authors.affiliation: Department of Chest Diseases, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Samah
authors.initials: S
authors.lastname: Selim
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
authors.forename: Maggie M
authors.initials: MM
authors.lastname: Abbassi
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
authors.forename: Nirmeen A
authors.initials: NA
authors.lastname: Sabry
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001249:Asthma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D004534:Egypt; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D006887:Hydroxycholecalciferols / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013147:Spirometry; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D050071:Bone Density Conservation Agents; D006887:Hydroxycholecalciferols; D014807:Vitamin D; C104450:25-hydroxyvitamin D; C008088:alfacalcidol