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GPs should routinely test COPD patients for vitamin D status, says study



GPs should routinely test vitamin D status in COPD patients as supplementation could reduce the rate of exacerbations, new research has found.

Primary care researchers concluded that vitamin D supplementation may ‘safely and substantially’ reduce the risk of exacerbations in COPD patients with low baseline levels of vitamin D, and that COPD patients should therefore routinely have their vitamin D levels investigated.

The study was carried out by researchers at Queen Mary University of London and pooled the results of four clinical trials investigating the effects of vitamin D in just under 500 COPD patients.

They found that compared to placebo, vitamin D supplementation reduced the rate of COPD exacerbations by 45% in patients with baseline vitamin D levels of less than 25nmol/L. It had no significant effect, however, on those with levels of greater than 25nmol/L.

Supplementation was also found to be safe, as it had no significant effects on the proportion of patients experiencing adverse outcomes or dying from any cause.

The researchers said that since COPD patients often have ‘profound’ vitamin D deficiency, they should be offered routine testing.

The paper said: ‘Our findings support a strategy of routinely testing vitamin D status in patients with COPD who experience exacerbations and offering supplementation to those with circulating 25(OH)D concentrations of less than 25 nmol/L.’

Research published in November showed that GPs were ordering three times as many diagnostic tests in 2015 as they were in 2000, with vitamin D tests among the three tests showing the greatest increases in GP ordering. 

Guidelines released by the National Osteoporosis Society in December aimed to clarify if and when GPs should order vitamin D blood tests, saying that only patients at ‘high risk’ of vitamin D deficiency should be tested

Thorax 2019; available online 11th January