- D-Lay Study Findings were recently presented at ECTRIMS, discussing vitamin D’s potential benefits in early MS management.
- While D-Lay may seem to contrast with PrevANZ findings, both studies, with some variations in design, emphasise similar messages about vitamin D in MS treatment.
- Vitamin D may offer a small benefit for overall health, but it is not a standalone treatment for managing MS.
What is the Role of Vitamin D in MS?
New research continues to explore the role of vitamin D in the prevention and management of multiple sclerosis (MS). With two recent studies, D-Lay MS from France and PrevANZ from Australia and New Zealand, people with MS are looking for clear answers about whether vitamin D can help prevent the progression of MS.
What Did the PrevANZ Trial Find?
The PrevANZ trial focused on people with clinically isolated syndrome (CIS), a first neurological event, like optic neuritis, that could develop into MS. Researchers wanted to see if taking vitamin D3 supplements could prevent the transition from CIS to clinically definite MS.
- Study Design: Participants took daily doses of vitamin D3 (1,000, 5,000, or 10,000 international units (IU)) or a placebo for 48 weeks.
- Key Findings: The results showed that vitamin D did not significantly reduce the progression from CIS to MS compared to the placebo group. Around 58% of participants developed MS within the study period, and the rates were similar across all groups. The low dose (1000 IU/day) was just as effective as the higher doses.
- Conclusion: The study concluded that vitamin D, even at high doses, did not change the likelihood of progressing to MS within a year of experiencing CIS.
What Did the D-Lay MS Trial Find?
The D-Lay MS trial, which has yet to undergo peer review, also looked at people with CIS, aiming to determine whether high-dose, intermittent vitamin D supplementation could delay the onset of MS.
- Study Design: This trial used a high-dose regimen of 100,000 IU of vitamin D every two weeks over 24 months. Participants were monitored for signs of MS development through clinical evaluations and MRI scans.
- Key Findings: The D-Lay MS study found that those who took vitamin D experienced a longer time before showing new disease activity, such as new brain lesions or relapses, compared to those on placebo.
- Conclusion: The study suggested that vitamin D might delay the development of relapses or new lesions in people after their first episode. However, this does not mean it can stop or reverse disease progression once MS is diagnosed.
The Differences Between the Trials
At first, it might seem confusing that these two studies came to different conclusions about the role of vitamin D. However, understanding how they differ can help clarify things:
- Study Populations: Both studies focused on people with CIS, but PrevANZ had a shorter follow-up period of 1 year , while D-Lay MS followed participants for 2 years. This longer period might have given more time to observe effects in the D-Lay MS study.
- Vitamin D Dosage and Frequency: PrevANZ used a daily dosing regimen, while D-Lay MS used intermittent high doses. The different timing of vitamin D administration may influence how it affects the immune system.
- Baseline Vitamin D Levels: Importantly, more participants in the D-Lay MS study began with lower vitamin D levels (<50 nmol/L), whereas almost no participants in the PrevANZ study had levels this low. This difference may explain why D-Lay MS showed a potential reduction in relapse and lesion development, as vitamin D might have a greater impact on those starting with lower levels.
Together, the two studies suggest that vitamin D may have a small, beneficial effect in reducing the development of new lesions and relapses in early MS, particularly for people with low vitamin D levels.
What Does This Mean for People with MS?
If you have CIS or MS, you may be wondering whether you should consider taking vitamin D supplements. Here is what we know.
Vitamin D is still important for overall health and immune function. It is a good idea to have your vitamin D levels checked. Many people with MS choose to take vitamin D as part of their health regimen, typically around 1000 IU a day.
According to the Australian PrevANZ researchers, the above studies do not support the use of high dose Vitamin D (e.g., 5000 or 10,000 IU/day). However, they do support the use of low dose (1000 IU/day) Vitamin D in early MS.
Consult with your healthcare team before making any changes to your vitamin D intake. High doses of supplements, including Vitamin D, can have serious side effects and may not be suitable for everyone. Your doctor can advise you based on your individual needs and overall treatment plan.
Trusted Advice for Managing Your MS
The most important take home message is that vitamin D is not a standalone treatment for managing MS. The studies show that vitamin D alone has, at best, a small benefit, but does not replace the need for other therapies that are specifically designed to reduce relapses, new lesions, and slow MS progression.
The best approach is to keep in regular communication with your MS care team, who can provide guidance and therapy tailored to your situation. They can help you integrate vitamin D into a broader plan that includes medications, lifestyle adjustments, and other treatments designed to improve your quality of life and manage your symptoms effectively.
References:
Butzkueven, H., Ponsonby, A.-L., Stein, M. S., Lucas, R. M., Mason, D., Broadley, S., Kilpatrick, T., Lechner-Scott, J., Barnett, M., Carroll, W., Taylor, B. V., & the PREVANZ Investigators. (2024). Vitamin D did not reduce multiple sclerosis disease activity after a clinically isolated syndrome. Brain, 147, 1206–1215. https://doi.org/10.1093/brain/awad409
Thouvenot, E., Laplaud, D., Lebrun-Frenay, C., et al. (2024). High-dose cholecalciferol reduces multiple sclerosis disease activity after a clinically isolated syndrome: Results of a 24-month placebo-controlled randomized trial (D-Lay MS). Abstract presented at the 40th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), Copenhagen, Denmark.
