Vitamin D and multiple sclerosis: what are the guidelines for a reliable clinical trial?

Abstract

Evaluation of: Mowry EM, Krupp LB, Milazzo M et al. Vitamin D status is associated with relapse rate in pediatric-onset multiple sclerosis. Ann. Neurol. 67, 618–624 (2010).

In 1960, Sir Donald Acheson suggested a link between multiple sclerosis and solar radiation. Some 50 years and numerous studies later, there is still no certainty about the role of UV or vitamin D, the sun-induced hormone, on the course of multiple sclerosis. In order to further clarify this issue, the article by Mowry et al. assesses the level of vitamin D in patients at the time of multiple sclerosis onset and correlates it with the number of subsequent clinical relapses. The conclusion is that every 10 ng/ml increase in the adjusted vitamin D level is associated with a 34% decrease in the rate of relapse. This result reinforces the rationale for a randomized double-blind placebo-controlled clinical trial. Several criteria for a well-designed trial are proposed.

Keywords::

• clinical trial
• HLA-DRB1
• multiple sclerosis
• pediatric onset
• relapse
• sun exposure
• ultraviolet rays
• vitamin D

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.