Review Article

Vitamin D as an Adjunctive Treatment to Standard Drugs in Pulmonary Tuberculosis Patients: An Evidence-Based Case Report

Table 5

Summary of the included systematic reviews and meta-analyses.

AuthorStudy populationVitamin D (Method of administration, dose)ResultsComments

Wallis et al. (2016)Adult patients with PTBVitamin D given orally or intramuscularly at total doses of 2.5 mg to 30 mg.In general, vitamin D was not shown to reduce the treatment time (except for one study). Supplementation was found to be well-tolerated and safe. Concern for the paradoxical reaction in the vitamin D subjects (i.e., disease worsening despite microbiological improvement) resulting in surgical or radiological intervention or deaths.The authors argued that the paradoxical effects of vitamin D are due to the different baseline characteristics, mainly the extent of vitamin D deficiency.
The authors highlighted the possibility of genetic polymorphisms in vitamin D receptor or enzymes involved in vitamin D metabolism
Wang et al. (2018)Adult patients with PTBVitamin D given intramuscularly (50,000 IU - 60,000 IU) or orally 2.5 mg every 1–2 weeks)Vitamin D supplementation showed no influence on the improvement of sputum smear-negative conversion rates (RR = 0.99; 95% CI = 0.91 to 1.07; p = 0.77).
There was no significant difference in the serious adverse events between the vitamin D supplementation group and the placebo group (RR = 1.03; 95% CI = 0.25 to 4.31; p = 0.96).
The authors stated that a higher dose and longer treatment period of vitamin D are needed in order to achieve a favorable treatment effect.
Wu et al. (2018)Patients above 16 years old that were newly diagnosed with PTB and who were on initial anti-TB treatmentVitamin D given at different doses ranging from 1000 IU/day to 600,000 IU/month at different intervalsVitamin D supplementation increased the sputum smear proportion conversion (OR = 1.21, 95% CI = 1.05–1.39, p = 0.007) and the sputum culture conversion (OR = 1.22, 95% CI = 1.04–1.43, p = 0.02).Although this study found that vitamin D is beneficial in increasing the overall effect of sputum smear conversion, no difference was found for the conversion at the 8th week. The authors also reported that vitamin D does not improve other parameters such as TB score, CRP, ESR, and blood indices.

PTB: Pulmonary Tuberculosis; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate.