O3249: The Effect of Vitamin D Supplementation on Vaso-occlusive Crisis (VOC) in Children with Sickle Cell Disease (SCD)

Background: sickle cell disease (SCD) is hemolytic anemia associated with a pain crisis that often requires hospitalization. Vitamin D deficiency is frequent among patients with SCD, with a prevalence ranging from 56% to 96%. The etiology is multifactorial: dark skin color, limited sunlight exposure, poor nutritional intake, and renal dysfunction are the most important factors.

Purpose:
We aimed to evaluate the effects and safety of vitamin D3 supplementation on the vaso-occlusive crisis in SCD Children.

Methods: This clinical trial was conducted in Nizwa city, Sultanate of Oman, from June 2021 to May 2022. Patients were recruited at Nizwa Hospital. Following formal consent, (n=46 )participants with ages ranging from 6 to 12 years. They were randomly assigned in a 1:1 ratio into 2 groups: the vitamin D supplementation group(n=23) and the placebo group (n=23). The supplementation group received 50,000 IU of vitamin D3 monthly for 6 months. The placebo group received placebo capsules (identical to vitamin D in appearance). A good response to treatment was defined as more than a 50% decrease in the monthly VOC frequency and hospitalization.

Results: A good response was observed in 18 children (78.26%) in the vitamin D3 supplementation group and 10 children (43,47%) in the placebo group, and vitamin D3 supplementation was significantly more effective than placebo (P =.01). Comparisons of Vaso-occlusive crisis (VOC) attacks before and after intervention in the vitamin D3 supplementation group and placebo group showed that vitamin D3 supplementation to SCD children with VOC was more effective than the placebo group in the reduction of monthly frequency, severity, duration, and disability of the attacks & hospitalization.

Conclusion: Accordingly, vitamin D3 supplementation may improve Vaso-occlusive crisis (VOC)attacks in children with SCD, by monthly administration of vitamin D 50,000 IU. Further randomized controlled trials with larger sample sizes and a longer duration of follow-up are recommended,
Vitamin D3 supplementation in SCD children with Vaso-occlusive crisis (VOC) could be a well-tolerated, inexpensive, safe, and effective strategy.