PMID- 31371976
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231013
IS  - 1176-6336 (Print)
IS  - 1178-203X (Electronic)
IS  - 1176-6336 (Linking)
VI  - 15
DP  - 2019
TI  - Vitamin D supplementation for the prevention or depletion of side effects of 
      therapy with alemtuzumab in multiple sclerosis.
PG  - 891-904
LID - 10.2147/TCRM.S188941 [doi]
AB  - PURPOSE OF REVIEW: Not only the multiple sclerosis specialist but also the 
      general neurologist and primary care practitioner are increasingly aware of 
      possible adverse events (AEs) by treatment with alemtuzumab (over 47% risk of 
      secondary autoimmune-mediated diseases). Vitamin D supplementation's effect (VDS) 
      to reduce these autoimmune AEs is poorly performed in routine practice. This 
      article seeks to justify why this simple, inexpensive, patient-friendly therapy 
      should be seriously discussed. RECENT FINDINGS: Patients who have developed 
      autoimmunity also show a high basal level of IL-21, a cytokine which increases 
      the growth of auto-reactive T-cells. For side effects such as thyroid 
      dysfunction, autoimmune thrombocytopenia, autoimmune hemolytic anemia, autoimmune 
      hepatitis, diabetes mellitus type 1, and alopecia areata/alopecia totalis, VDS 
      may have an impact on the immunological mechanism, in particular lowering levels 
      of IL-17 and IL-21. SUMMARY: The potential role of vitamin D in influencing 
      autoimmune diseases is evident. If a life-threatening side-effect can be 
      prevented by high-dose VDS, it is ethical to initiate this add-on therapy despite 
      contradictory results in studies on the effectiveness of VDS.
FAU - Goischke, Hans-Klaus
AU  - Goischke HK
AUID- ORCID: 0000-0002-5192-4348
AD  - Independent Research, Internal Medicine, Rehabilitation Medicine, Social 
      Medicine, Bad Bruckenau, Bavaria, Germany.
LA  - eng
PT  - Journal Article
DEP - 20190712
PL  - New Zealand
TA  - Ther Clin Risk Manag
JT  - Therapeutics and clinical risk management
JID - 101253281
PMC - PMC6636607
OTO - NOTNLM
OT  - adverse events
OT  - alemtuzumab
OT  - autoimmune hepatitis
OT  - hemolytic and endocrine diseases
OT  - vitamin D supplementation
COIS- The author declares no conflicts of interest in this work.
EDAT- 2019/08/03 06:00
MHDA- 2019/08/03 06:01
PMCR- 2019/07/12
CRDT- 2019/08/03 06:00
PHST- 2019/03/20 00:00 [received]
PHST- 2019/06/16 00:00 [accepted]
PHST- 2019/08/03 06:00 [entrez]
PHST- 2019/08/03 06:00 [pubmed]
PHST- 2019/08/03 06:01 [medline]
PHST- 2019/07/12 00:00 [pmc-release]
AID - 188941 [pii]
AID - 10.2147/TCRM.S188941 [doi]
PST - epublish
SO  - Ther Clin Risk Manag. 2019 Jul 12;15:891-904. doi: 10.2147/TCRM.S188941. 
      eCollection 2019.