ArticleJAMA neurology2014
Vitamin D as an early predictor of multiple sclerosis activity and progression.
Article in JAMA neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 194 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
194 citing papers in PubMed, 7 syntheses or guidelines pooled it, 505 citations in OpenAlex.
- Endocrine-Immune Crosstalk in Pediatric Autoimmune Diseases: A Systematic Review of the Role of Micronutrients, with Emphasis on Vitamin D.Nutrients · 2026Pooled it
- Vitamin D deficiency and multiple sclerosis relapse: a meta-analysis.Frontiers in neurology · 2025Pooled it
- Pooled it
- Clinical and Imaging Outcomes after Vitamin D Supplementation in Patients with Multiple Sclerosis: A Systematic Review.Nutrients · 2023Pooled it
- Vitamin D Supplementation and Mental Health in Multiple Sclerosis Patients: A Systematic Review.Nutrients · 2021Pooled it
- Guideline
- Treatment with disease-modifying drugs for people with a first clinical attack suggestive of multiple sclerosis.The Cochrane database of systematic reviews · 2017Pooled it
- Twelve Weeks of Intermittent Caloric Restriction Diet Mitigates Neuroinflammation in Midlife Individuals with Multiple Sclerosis: A Pilot Study with Implications for Prevention of Alzheimer's Disease.Journal of Alzheimer's disease : JAD · 2023Trial
- Dietary conjugated linoleic acid links reduced intestinal inflammation to amelioration of CNS autoimmunity.Brain : a journal of neurology · 2021Trial
- Vitamin D related genetic polymorphisms affect serological response to high-dose vitamin D supplementation in multiple sclerosis.PloS one · 2021Trial
- Vitamin D supplementation and serum neurofilament light chain in interferon-beta-1b-treated MS patients.Brain and behavior · 2020Trial
- Vitamin D, smoking, EBV, and long-term cognitive performance in MS: 11-year follow-up of BENEFIT.Neurology · 2020Trial
- Vitamin D supplementation has no effects on progression of motor dysfunction in amyotrophic lateral sclerosis (ALS).European journal of clinical nutrition · 2020Trial
- Randomized trial of daily high-dose vitamin DNeurology · 2019Trial
- Cholecalciferol in relapsing-remitting MS: A randomized clinical trial (CHOLINE).Neurology(R) neuroimmunology & neuroinflammation · 2019Trial
- Exploring the effect of vitamin DMultiple sclerosis (Houndmills, Basingstoke, England) · 2018Trial
- Efficacy and safety outcomes in vitamin D supplement users in the fingolimod phase 3 trials.Journal of neurology · 2018Trial
- Vitamin D Status Does Not Affect Disability Progression of Patients with Multiple Sclerosis over Three Year Follow-Up.PloS one · 2016Trial
- Vitamin D supplementation and systemic inflammation in relapsing-remitting multiple sclerosis.Journal of neurology · 2015Trial
- Vitamin D-binding protein levels do not influence the effect of vitamin D repletion on serum PTH and calcium: data from a randomized, controlled trial.The Journal of clinical endocrinology and metabolism · 2014Trial
134 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
17 authors at 11 institutions in 8 countries.
Funding
Abstract
importanceIt remains unclear whether vitamin D insufficiency, which is common in individuals with multiple sclerosis (MS), has an adverse effect on MS outcomes.
objectivesTo determine whether serum concentrations of 25-hydroxyvitamin D (25[OH]D), a marker of vitamin D status, predict disease activity and prognosis in patients with a first event suggestive of MS (clinically isolated syndrome). DESIGN, SETTING, AND
participantsThe Betaferon/Betaseron in Newly Emerging multiple sclerosis For Initial Treatment study was a randomized trial originally designed to evaluate the impact of early vs delayed interferon beta-1b treatment in patients with clinically isolated syndrome. Serum 25(OH)D concentrations were measured at baseline and 6, 12, and 24 months. A total of 465 of the 468 patients randomized had at least 1 25(OH)D measurement, and 334 patients had them at both the 6- and 12-month (seasonally asynchronous) measurements. Patients were followed up for 5 years clinically and by magnetic resonance imaging. MAIN OUTCOMES AND MEASURES: New active lesions, increased T2 lesion volume, and brain volume on magnetic resonance imaging, as well as MS relapses and disability (Expanded Disability Status Scale score).
resultsHigher 25(OH)D levels predicted reduced MS activity and a slower rate of progression. A 50-nmol/L (20-ng/mL) increment in average serum 25(OH)D levels within the first 12 months predicted a 57% lower rate of new active lesions (P < .001), 57% lower relapse rate (P = .03), 25% lower yearly increase in T2 lesion volume (P < .001), and 0.41% lower yearly loss in brain volume (P = .07) from months 12 to 60. Similar associations were found between 25(OH)D measured up to 12 months and MS activity or progression from months 24 to 60. In analyses using dichotomous 25(OH)D levels, values greater than or equal to 50 nmol/L (20 ng/mL) at up to 12 months predicted lower disability (Expanded Disability Status Scale score, -0.17; P = .004) during the subsequent 4 years. CONCLUSIONS AND RELEVANCE: Among patients with MS mainly treated with interferon beta-1b, low 25(OH)D levels early in the disease course are a strong risk factor for long-term MS activity and progression.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.