Very high-dose ergocalciferol is effective for correcting vitamin D deficiency in children and young adults with cystic fibrosis

Boas, Steven R.; Hageman, Joseph R.; Ho, Louisa T.; Liveris, Marissa

doi:10.1016/j.jcf.2009.04.004

« Previous Next »Journal of Cystic Fibrosis
Volume 8, Issue 4 , Pages 270-272, July 2009

Very high-dose ergocalciferol is effective for correcting vitamin D deficiency in children and young adults with cystic fibrosis

Steven R. Boas
- Cystic Fibrosis Center of Chicago, 2401 Ravine Way, Suite 302, Glenview. Illinois 60025, United States
- Department of Pediatrics, Evanston Hospital, 2650 Ridge Avenue, Evanston, Illinois 60201, United States
- Corresponding authors. Department of Pediatrics, Evanston Hospital, 2650 Ridge Avenue, Evanston, Illinois 60201, United States. Tel.: +1 847 570 1438; fax: +1 847 570 0231.
Joseph R. Hageman
- Department of Pediatrics, Evanston Hospital, 2650 Ridge Avenue, Evanston, Illinois 60201, United States
- Corresponding authors. Department of Pediatrics, Evanston Hospital, 2650 Ridge Avenue, Evanston, Illinois 60201, United States. Tel.: +1 847 570 1438; fax: +1 847 570 0231.
Louisa T. Ho
- Department of Medicine, Evanston Hospital, 2650 Ridge Avenue, Evanston, Illinois 60201, United States
Marissa Liveris
- Cystic Fibrosis Center of Chicago, 2401 Ravine Way, Suite 302, Glenview. Illinois 60025, United States

Received 27 February 2009; received in revised form 17 March 2009; accepted 3 April 2009.

Abstract

Approximately 10–80% of patients with Cystic Fibrosis (CF) have vitamin D deficiency. Obtaining therapeutic vitamin D levels has been a challenge for CF care providers using current recommended high-dose oral ergocalciferol (400,000 IU over 2 months). The objective of this study was to evaluate the safety and efficacy of a 2-week, very high dose ergocalciferol (700,000 IU over 14 days) repletion strategy in children and young adults with CF.

As part of a quality improvement initiative, a prospective cohort study was performed from January through May 2007. Phase I included identifying individuals with CF who were subtherapeutic in 25-OH D. In phase II, 50,000 IU of ergocalciferol was prescribed for a 14 day term and administered daily. During phase III, a post treatment 25-OH D level was obtained to determine improvement. Baseline demographics and clinical characteristics were obtained at study entry. Stratification of the post 25-OHD levels was defined.

Eighteen individuals with CF participated in the study. The mean age was 17±5 years (range 6–25 years). One hundred percent were pancreatic insufficient and required pancreatic enzyme replacement. All 18 had 25-OHD levels less than 30 ng/mL pre-treatment.

Seventeen of the 18 (94%) participants became therapeutic in the 2-week interval. No patients had values considered high abnormal (100–150 ng/mL) or toxic (>150 ng/mL). Mean change was noted at an increase of 37.3±22 ng/mL in the 2-week period (p<0.001). Pre and peripubertal individuals had a significantly greater increase in 25-OH D levels.

The results of this study demonstrate that very high dosing of vitamin D using oral ergocalciferol over a 14 day period is an effective strategy in achieving therapeutic levels of 25-OH vitamin D in children and young adults with CF. We believe this regimen deserves further study.

Keywords: Vitamin D deficiency, Cystic fibrosis, Ergocalciferol