Medical Bulletin 18/January/2023

Here are the top medical news for the day:

Vitamin D benefits and metabolism may depend on body weight: Study

Vitamin D is an essential nutrient involved in many biological processes, most notably helping our body absorb minerals, such as calcium and magnesium. While some of the vitamin D we need is made in the body from sunlight, vitamin D deficiencies are often treated with supplementation. Evidence from laboratory studies, epidemiologic research and clinical research has also suggested that vitamin D may play a role in the incidence and progression of cancer and cardiovascular disease, and it was this evidence that prompted the original VITAL trial.

The VITAL trial was a randomized, double-blind, placebo-controlled trial in 25,871 U.S. participants, which included men over the age of 50 and women over the age of 55. All participants were free of cancer and cardiovascular disease at the time of enrollment.

Reference:

Tobias, DK et al. “Association of Body Weight with Response to Vitamin D Supplementation and Metabolism” Jama Network Open DOI:10.1001/jamanetworkopen.2022.50681

Post liver transplant monitoring Epstein-Barr viral load may lower risk for rare post transplant complication

Primary infection with or reactivation of EBV can occur after liver transplant and can lead to PTLD. An Epstein-Barr virus viral load or EBV VL monitoring strategy, including the reduction of immunosuppression is hypothesized to reduce incidence of PTLD in adult transplant recipients -almost all IgG anti-EBV positive).

A study of adult recipients of liver transplants has found that monitoring transplant recipients for EBV VL helped to reduce risk for posttransplant lymphoproliferative disease (PTLD), a rare but serious potential complication of transplantation. The findings are published in Annals of Internal Medicine.

Reference:

Bastian N. Ruijter, MD et al,Annals of Internal Medicine,https://doi.org/10.7326/M22-0364

Long-term low-dose hydroxychloroquine linked to low risk for retinopathy

Hydroxychloroquine is recommended for patients with systemic lupus erythematosus and some other inflammatory conditions, but vision-threatening retinopathy is a serious long-term adverse effect. Guidelines recommend keeping dosing at 5 mg/kg of body weight per day or lower. However, available study evidence supporting this is relatively weak.

A cohort study of more than 3,000 persons who received hydroxychloroquine for 5 or more years with guideline-recommended serial retinopathy screening found that the overall risk for incident retinopathy was low, with most documented cases being mild. Higher hydroxychloroquine dose was associated with progressively greater risk. The findings are published in Annals of Internal Medicine.

Reference:

April M. Jorge et al,Annals of Internal Medicine.https://doi.org/10.7326/M22-2453