ReviewInfection2026
Potential value of vitamin D as adjunctive therapy in osteoarticular tuberculosis: a comprehensive review.
Review in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Osteoarticular tuberculosis (OATB) is one of the most common clinical types of extrapulmonary tuberculosis (EPTB), characterized primarily by progressive bone destruction and high morbidity. Standard anti-tuberculous chemotherapy has limited efficacy in reversing established bone damage. Vitamin D, a fat-soluble steroid hormone with immunomodulatory and bone-metabolic properties, shows promise as an adjunctive therapeutic agent. Mechanistically, vitamin D enhances anti-tuberculous immunity through multiple pathways: inducing antimicrobial peptide LL-37 expression, activating autophagic flux, and modulating Th1/Th17/regulatory T cell balance. At the bone level, vitamin D counteracts Mtb-induced destruction via the OPG/RANKL axis, Wnt/β-catenin signaling activation, and correction of secondary hyperparathyroidism. However, rifampicin-a cornerstone chemotherapy agent-accelerates vitamin D catabolism by inducing CYP3A4/CYP24A1, creating a clinically significant drug-nutrient interaction that exacerbates vitamin D depletion. Evidence supporting vitamin D supplementation remains predominantly derived from pulmonary tuberculosis (PTB) patients in randomized controlled trials (RCTs), with only one small-sample study specific to OATB (n = 41, 8 weeks). These PTB-derived trials employed single high-dose bolus regimens with 3-6 months follow-up, demonstrating modest benefits (HR 0.58-0.89) primarily in vitamin D-deficient subgroups, with negligible effects in replete populations. Direct applicability to OATB remains unverified. This review systematizes vitamin D's immunological and bone-metabolic mechanisms in OATB, critically appraises existing evidence quality and extrapolation limitations, and proposes an RCT framework with bone structural repair and functional recovery as primary endpoints. Our aim is to guide theoretical development and future clinical investigation of vitamin D as adjunctive therapy for OATB.
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Identifiers
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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.