Low serum level of vitamin d at time of diagnosis is associated with higher one-year remission rate in patients with newly diagnosed ra, treated aggressively during follow-up: post-hoc analyses of the cimestra trial

Background Vitamin D is often low in Rheumatoid Arthritis(RA), and immunomodulatory properties of vitamin D might be associated with disease-course in RA.(1)Objectives To evaluate association between baseline vitamin D metabolites and one-year remission, in newly diagnosed, treatment-naive RA patients, aggressively treated during follow-up.Methods The CIMESTRA-cohort comprises 160 newly diagnosed RA patients, treated aiming at remission with methotrexate and intraarticular steroid, further randomized 1:1 to ciclosporine or placebo-ciclosporine.(2) A total of 158 patients had vitamin D metabolites measured at time of diagnosis. Dietary vitamin D supplementation was recommended in accordance with the national guidelines. Serum vitamin Dtotal (sum of 25OHD2 and 25OHD3) and 1,25(OH)2D at time of diagnoses were measured by LC-MS/MS or RIA. Dtotal were dichotomized at 50 nmol/l, and 1,25(OH)2D categorized in tertiles. Primary outcome was remission (DAS28-CRP