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Vitamin D Supplementation in Individuals With a Chronic Spinal Cord Injury

Phase 3
Completed
Conditions
Spinal Cord Injuries
Vitamin D Deficiency
Interventions
Registration Number
NCT04652544
Lead Sponsor
Swiss Paraplegic Research, Nottwil
Brief Summary

The main objective of this placebo-controlled randomized double-blinded study is to investigate the effect of vitamin D supplementation on vitamin D status (25(OH)D concentration in the blood) among individuals with a chronic spinal cord injury (SCI). Further, the effects of vitamin D supplementation on several other parameters (e.g. bone density and mood) are investigated, which could reveal positive secondary effects of supplementation that are especially relevant for clinical practice.

Detailed Description

The purpose of this study is to evaluate the influence of vitamin D supplementation among individuals with chronic SCI. The primary aim is to study whether different dosages (24'000 IU/month or 48'000 IU/month) of vitamin D supplementation over 12 months will lead to differences in vitamin D status as well as differences in several other outcomes. The use of a placebo group supports the evaluation of dose-response effects of vitamin D supplementation on the primary outcome (vitamin D status) and secondary outcomes (including bone density and mood) that are not only supported by randomized controlled trial standards but also informative in clinical practice.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
50
Inclusion Criteria
  • Informed Consent to the present study as documented by a signature
  • Chronic (> 3 years) traumatic or non-traumatic spinal cord injury with a sub-C4-level lesion
  • Wheelchair dependency during activities of daily living
  • vitamin D status <75nmol/L
Exclusion Criteria
  • Contraindications to the investigational product
  • Clinically relevant disorders,
  • Pressure ulcer grade 3 or 4
  • Pregnancy, breastfeeding
  • Vitamin D supplementation (> 400 IU/day) within the last 12 months
  • Visiting a country with increased sun exposure (below the 37th parallel north) within the last month before study enrolment or during the study
  • Fractures in both arms and/or both legs within the last five years

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
"Low" dosePlaceboOne vial with 600 µg cholecalciferol (corresponding to a total of 24'000 IU vitamin D) and one vial with placebo every month.
PlaceboPlaceboTwo vials with a placebo every month.
"Low" doseCholecalciferol (Vitamin D3)One vial with 600 µg cholecalciferol (corresponding to a total of 24'000 IU vitamin D) and one vial with placebo every month.
"High" doseCholecalciferol (Vitamin D3)Two vials with 600 µg cholecalciferol each (corresponding to a total of 48'000 IU vitamin D) every month.
Primary Outcome Measures
NameTimeMethod
Vitamin D status0 to 12 months

Serum levels of 25(OH)D in nmol/L

Secondary Outcome Measures
NameTimeMethod
Bone densityAt baseline and after 12 months

Measurements of the forearm (radius), hip (femoral neck) and knee (distal femur and proximal tibia) will be performed using dual-energy X-ray absorptiometry (DXA) scans. T-values will be reported.

Chronic painAt 0, 3, 6, 9, 12 months

The occurrence of pain since the last visit is assessed by one question of the SCI Secondary Conditions Scale (Kalpakjian, Scelza et al. 2007), providing a five-step rating (0-4) with a higher score indicating a worse outcome.

Recent painAt 0, 3, 6, 9, 12 months

The occurrence, kind, location and interference of pain during the last week is assessed using questions of the adapted version of the International SCI Pain Basic Data Set (Widerström-Noga, Biering-Sørensen et al. 2008). The interference of pain is measured on a 11-step scale (0-10), with total range 0-30 and higher scores indicating worse outcomes.

Pressure injuriesAt 0, 3, 6, 9, 12 months

The occurrence, localization and severity of pressure injuries is assessed by the exact questions of the first-wave questionnaire of the Swiss Spinal Cord Injury Cohort Study (SwiSCI) survey (Post, Brinkhof et al. 2011, Brinkhof, Fekete et al. 2016). The severity or grade is assessed using the European and US National Pressure Ulcer Advisory panels' (EPUAP-NPUAP) classification (National Pressure Ulcer Advisory Panel and Alliance. 2014), using a 4 point scale (1-4) and higher grades indicating worse outcomes.

MoodAt 0, 3, 6, 9, 12 months

Assessed by the Hospital Anxiety and Depression Scale (HADS) questionnaire, using a 4-step scale (1-4) with a total range of 14-56 and higher scores indicating worse outcomes.

FatigueAt 0, 3, 6, 9, 12 months

Assessed by the Fatigue Severity Scale (FSS) questionnaire, using a 8-step scale (1-7) with total range 9-63 and higher scores indicating worse outcomes.

Trial Locations

Locations (1)

Swiss Paraplegic Centre

🇨🇭

Nottwil, Luzern, Switzerland

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