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Vitamin D deficiency is common in patients with RA and linked to disease activity, but circulating levels are unaffected by TNFα blockade: results from a prospective cohort study
  1. Paul Welsh1,
  2. Mike J L Peters2,
  3. Iain B McInnes1,
  4. Willem F Lems2,
  5. Paul T Lips2,
  6. Gayle McKellar3,
  7. Susan Knox4,
  8. A Michael Wallace4,,
  9. Ben A C Dijkmans2,5,
  10. Michael T Nurmohamed2,5,
  11. Naveed Sattar1
  1. 1BHF GCRC, University of Glasgow, Glasgow, UK
  2. 2VU University Medical Centre, Amsterdam, The Netherlands
  3. 3Centre for Rheumatic Diseases, Glasgow Royal Infirmary, Glasgow, UK
  4. 4Department of Clinical Biochemistry, Glasgow Royal Infirmary, Glasgow, UK
  5. 5Jan van Breemen Institute, Amsterdam, The Netherlands
  1. Correspondence to Dr Paul Welsh, British Heart Foundation Glasgow Cardiovascular Research Centre, 126 University Place, Faculty of Medicine, University of Glasgow, Glasgow G12 8TA, UK; p.welsh{at}

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Preliminary data suggest an inverse relationship between serum 25-hydroxyvitamin D (25OHD) levels and disease activity score (DAS) in rheumatoid arthritis (RA).1 Furthermore, data for an apparent beneficial effect of statins on circulating 25OHD concentrations2 have been speculated to be attributable to statin ‘pleiotropic’ anti-inflammatory effects. Serum 25OHD concentrations also fall in the acute phase following surgery.3 Collectively, such data suggest that systemic inflammation may negatively modulate serum 25OHD concentrations. On this basis, we hypothesised that serum 25OHD levels in patients with RA would rise after short-term administration of a tumour necrosis factor α (TNFα) blocking agent, adalimumab.

Our work involved 170 consecutive patients with RA at the rheumatology outpatient clinic of the Jan van Breemen Institute, Amsterdam (latitude 52.3°N). Patients were either treated with adalimumab alone (40 mg every 2 weeks) or with adalimumab and concomitant drug-modifying antirheumatic drugs.4 Other antirheumatic treatment remained unchanged during the study. All …

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  • PW and MJLP are joint first authors

  • MTN and NS are joint senior authors

  • Deceased

  • Funding This study was facilitated by the Clinical Research Bureau of the Jan van Breemen Institute which receives financial support from the Dutch Arthritis Association. MJP received a EULAR bursary and this research was conducted while he was an ARTICULUM Fellow.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the local ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.